r 


REESE  LIBRARY 

OF  THE    • 

UNIVERSITY  OF  CALIFORNIA. 

Deceived  ,  igo     . 

Accession  No.    -85524   .   Class  No. 


THE  SOLDIER'S 


FIRST  AID  HANDBOOK, 


COMPRISING 


A  SERIES   OF   LECTURES 


TO 


MEMBERS  OF  THE  HOSPITAL  CORPS  AND 
COMPANY  BEARERS. 


BY 

WILLIAM  D.  DIETZ, 

Captain  and  Assistant  Surgeon^  U.  S.  Army. 


NEW  YORK: 

JOHN    WILEY    &    SONS, 

53  EAST  TENTH  STREET. 
1891. 


'SSSg 


COPYRIGHT,  1891, 

BY 
JOHN  WILEY  &  SONS. 


ROBERT  DRUMMOND,  FERRIS  BROS., 

Etectrotyper,  Printers, 

444  and  446  Pearl  St.  326  Pearl  Street, 

New  York.  New  York. 


PREFACE. 


THIS  manual  consists  in  the  main  of  a  series  of 
lectures  delivered  to  members  of  the  Hospital 
Corps  and  company  bearers,  and  covering  the 
ground  indicated  in  existing  orders.  Originality 
is  not  claimed  for  it;  it  is  believed,  however, 
that  the  subject-matter  has  been  presented  in 
available  form.  The  writer's  aim  has  been  to 
supply  an  elementary  "  Soldier's  Handbook,"  de- 
void of  technicalities,  and  limited  in  its  scope  to 
the  information  required  by  the  bearer  who 
renders  "  First  Aid,"  only.  It  is  hoped,  more- 
over, that  the  manual  may  contribute  to  facilitate 
the  work  of  the  medical  officer  in  the  preparation 
of  his  lectures  to  enlisted  men,  and,  further,  be  of 
use  to  line  officers  who,  in  command  of  detach- 
ments, may  have  to  meet  emergencies  in  the 
absence  of  the  surgeon. 

ALCATRAZ  ISLAND,  CALIFORNIA,  December,  1890. 

"85526 


TABLE  OF  CONTENTS. 


PREFACE iii 

PRELIMINARY  REMARKS:   The  Organization  and  Duties  of 

the  Hospital  Corps  and  Company  Bearers I 

PART  I. 

THE  HUMAN  BODY. 

THE  SKELETON 2 

The  Skull 3 

The  Cranium 3 

The  Face 4 

The  Trunk 5 

The  Spinal  Column 5 

The  Thorax 5 

The  Pelvis 6 

The  Limbs 6 

The  Upper  Limbs  6 

The  Lower  Limbs 7 

The  Joints 8 

THE  SOFT  PARTS 9 

The  Muscles 9 

Fatty  Tissue 9 

Connective  Tissue 9 

The  Skin 9 

The  Organs  of  the  Cranial  and  the  Spinal  Cavity 10 

The  Brain ...  10 

The  Spinal  Cord II 

The  Cerebro-spinal  Nerves n 

v 


VI  TABLE   OF  CONTENTS. 

PAGE 

The  Organs  of  the  Lesser  Cavities  of  the  Head 12 

The  Organs  of  the  Chest 12 

The  Lungs ...  12,  13 

The  Heart I3i  14 

The  Organs  of  the  Abdominal  and  Pelvic  Cavities 15 

The  Stomach 15, 16 

The  Intestines 16 

The  Liver 16 

The  Pancreas 17 

The  Spleen 17 

The  Kidneys. « 17 

The  Ureters 17 

The  Bladder 17 

The  Urethra 17 

The  Seminal  Vesicles 17 

The  Peritoneum 18 

Location  of  the  Principal  Blood-vessels , 18,  19,  20 

PART  II. 

FIRST  AID   ON  THE  BATTLE-FIELD. 

GENERAL  MANAGEMENT  OF  MEN  WOUNDED  IN  BATTLE.  ...     21 

The  Position  of  the  Wounded  upon  the  Litter 22,  23 

The  Bearer's  Equipment 24 

The  Use  ot  First  Aid  Packets 25,  26 

FIRST  AID  TREATMENT  OF  HEMORRHAGE 26,  27 

Capillary  Hemorrhage 27 

Venous  Hemorrhage 28 

Arterial  Hemorrhage 28,  29 

Hemorrhage  from  the  Artery  of  the  Neck 30 

"       "  Artery    of    the    Arm    in     its 

Uppermost  Portion 30 

from  the  Artery  of  the  Arm  in  its  Lower 

Portion 31 

from  the  Arteries  of  the  Forearm 31 

"  "       "         "        "    "    Hand 31 

"  "      "         "        "    "   Thigh 32 

"       "         "        "    "    Leg 32 

"      "         "        "    "   Foot 32 


TABLE  OF  CONTENTS.  vii 

PAGE 

Internal  Hemorrhage 32 

Fainting 33 

FIRST  AID  TREATMENT  OF  WOUNDS 33,  34 

Contusions 34 

Contused  Wounds 34 

Incised  Wounds 35 

Punctured  Wounds 35,  36 

Lacerated  Wounds 36 

Gunshot  Wounds 36,  37 

Shock 37,38 

FIRST  AID  TREATMENT  OF  FRACTURES 38 

Extemporary  Splints 39 

Fracture  of  the  Upper  Arm 39,  40 

"         "    "    Lower  End  of  the  Arm 40 

«         «    «   Forearm  40 

"    "   Finger 41 

"    "    Thigh 41 

"         "    "    Knee-pan 41 

"    "   Leg 41 

"         "    "    Spine 42 

"         "    "   Shoulder-blade,  Hip-bone,  or  Rib 42 

"    "Collar-bone 42 

"    "    Skull 42 

"    "   Jaw 42 

Compound  Fractures 42 

FIRST  AID  TREATMENT  OF  DISLOCATIONS 43 

FIRST  AID  TREATMENT  OF  SPRAINS 43 

PROCEDURES  TO  BE  ADOPTED  IN  CASES  OF  SUSPENDED 

ANIMATION 43,  44,  45 

Artificial  Respiration 44 

Sylvester's  Method 44,  45 

PART  III. 

MANAGEMENT  BY  THE  BEARER  OF  ORDINARY 
ACCIDENT?  AND  EMERGENCIES. 

GENERAL  RULES  TO  BE  OBSERVED  IN  CASES  OF  ACCIDENT.  .     46 
HEMORRHAGE,     WOUNDS,     FRACTURES.      DISLOCATIONS, 

SPRAINS.     ( Vide  Part  II.) 46 


Vlll  TABLE   OF   CONTENTS. 

PAGE 

CONDITIONS  CAUSING  Loss  OF  CONSCIOUSNESS 47 

Fainting  and  Shock 48 

Concussion  of  the  Brain 48 

Compression  of  the  Brain 48 

Apoplexy 48 

Sunstroke 49 

Heat  Exhaustion 49 

Intoxication , 50 

Epileptic  Seizures 50 

Poisons 50,  51 

ASPHYXIA 51 

Drowning 51,  52,  53 

Strangulation  from  Hanging 53 

Suffocation  with  Gases 53 

Suffocation  from  Foreign  Bodies  in   the  Windpipe    or 

Gullet 54 

BURNS  AND  SCALDS 55 

Slight  Burns  or  Scalds 55 

Burns  or  Scalds  causing  Blisters 55 

Deep  Burns  or  Scalds 56 

Shock  occurring  as  a  Result 56 

FREEZING 56 

General  Freezing 56 

Frost-bites 56,  57 

Chilblains 57 

SORENESS  OF  THE  FEET 57 

HEMORRHAGE    FROM    THE    NOSE,   LUNGS,   STOMACH,   OR 

BOWELS 58 

Nose-bleed  58 

Hemorrhage  from  the  Lungs 58,  59 

"       "    Stomach 59 

"               "      "    Bowels 59 

POISONING 59-  70 

General  Measures  and  Remedies 60,  61 

Emetics 61 

Alkaline  Antidotes  62 

Acid  Antidotes 62 

Bland  Liquids 62 

Stimulants 63 

Laudanum 63 


TABLE  OF  CONTENTS.  IX 


Forcible  Administration  of  Remedies 63,  64 

Poisoning  from  Unknown  Substances 64 

Corrosive  Poisons 64 

Sulphuric,  nitric,  and  hydrochloric  acids 65 

Carbolic  acid 65 

Oxalic  acid 65 

Ammonia,  soda,  and  potash 65 

Corrosive  sublimate 65,  66 

Nitrate  of  silver 66 

Phosphorus 66 

Irritant  Poisons 66 

Arsenic 66,  67 

Tartar  emetic 67 

Lead 67 

Copper 68 

Iodine 68 

Irritant  animal  and  vegetable  substances 68 

Tainted  meat,  tainted  fish,  toadstools 68 

Neurotic  Poisons ...     68 

Opium 69 

Chloral 69 

Hydrocyanic  acid 69 

Irritant  narcotics 70 

Poisoned  Wounds 70 

Bites  of  venomous  serpents 70 

Bite  of  a  mad  dog TO,  71 

Stings  of  tarantulas,  etc 71 

Rhus  Poisoning 71 

TABLE  OF  POISONS 71,  72,  73,  7^ 

FOREIGN  BODIES  IN  THE  EYE,  EAR,  OR  NOSE 74,  75,  76 

Foreign  Bodies  in  the  Eye 74,  75 

Foreign  Bodies  in  the  Ear 76 

Foreign  Bodies  in  the  Nose 77 

MISCELLANEOUS  HINTS 77,  78 

Constipation » 77 

Colic 77,  78 

Cholera  Morbus. 78 

Diarrhoea 78 

SIGNS  OF  DEATH 78,  79 

BOOKS  OF  REFERENCE 81 


THE  SOLDIER'S  FIRST  AID  HANDBOOK. 


PRELIMINARY   REMARKS. 
ORGANIZATION  AND  DUTIES  or  THE  HOSPITAL 

CORPS  AND  THE  COMPANY  BEARERS. 

ACCORDING  to  the  regulations  governing  the 
United  States  Army,  the  Hospital  Corps  consists 
of  hospital  stewards,  acting  hospital  stewards,  and 
privates  regularly  enlisted  for  and  attached  to  the 
Medical  Department,  and  performing  all  hospital 
services  in  garrison  and  in  the  field.  In  time  of 
war,  this  corps  renders  the  necessary  ambulance 
service  under  such  officers  of  the  Medical  Depart- 
ment and  assistants  as  may  be  duly  detailed. 

Moreover,  the  regulations  require  that  in  each 
company  throughout  the  army  four  men,  to  be 
known  as  company  bearers,  be  designated  for  in- 
struction in  the  duties  of  litter-men  and  the  meth- 
ods of  rendering  first  aid  to  the  disabled.  During 
an  engagement,  acting  under  orders  of  their  com- 
manding officers  and  supervision  of  their  regimen- 
tal surgeon,  they  render  first  aid  to  thejr  wounded 


2      THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

comrades  and  carry  them  to  the  rear.  Upon  be- 
ing relieved  by  members  of  the  Hospital  Corps, 
they  immediately  join  their  companies. 

Collectively,  privates  of  the  Hospital  Corps 
and  the  men  designated  from  the  companies  will 
herein  be  known,  for  the  sake  of  brevity,  as  bear- 
ers. 


PART   I. 

THE  HUMAN  BODY. 

In  order  that  the  bearer  may  be  enabled  intel- 
ligently to  afford  first  aid  to  the  injured  or  to 
care  for  the  sick,  he  requires,  first  of  all,  a  general 
knowledge  of  the  structure  of  the  human  body 
and  of  the  functions  of  the  principal  organs. 
Armed  with  this  knowledge,  elementary  though 
it  must  be,  he  will  frequently  be  in  a  position  to 
give  untold  relief  to  his  stricken  comrades,  or 
even,  by  the  application  of  a  few  simple  princi- 
pies  learned,  to  save  a  life  that  without  his  inter- 
vention would  have  been  lost. 

The  human  body  is  composed  of  the  skeleton 
and  the  soft  parts. 

The  Skeleton  comprises  the  bony  parts  of  the 
system.  It  is  the  framework  of  the  body,  sup- 
ports the  soft  parts,  encloses  the  vital  organs  in 
its  cavities,  and  furnishes  a  system  of  levers  acted 
upon  by  the  muscles,  Bones  may  be  classed  as 


THE   HUMAN   BODY.  3 

long,  short,  flat,  or  irregular,  according  to  their 
shape.  The  thigh-bone,  for  instance,  js  a  long 
bone;  the  bones  of  the  wrist  are  of  the  short 
variety  ;  the  hip-bone  is  a  flat  bone,  and  the  lower 
jaw  an  irregular  one.  The  skeleton  may  be  divided 
into  skull,  trunk,  and  limbs  ;  in  the  adult  it  is  com- 
posed of  two  hundred  and  thirty-two  bones,  in- 
cluding the  teeth. 

The  Skull  consists  of  the  cranium,  which  con- 
tains the  brain,  and  the  face. 

The  Cranium  is  made  up  of  the  eight  bones 
which  enclose  the  cranial  cavity.  The  cranial 
bones  are  : 

One  occipital  bone,  which  is  located  at  the  back 
and  lower  portion  of  the  skull,  and  through  a 
large  opening  in  which  the  brain  and  spinal  cord 
communicate ; 

Tw parietal  bones,  forming  by  their  union  the 
sides  and  roof  of  the  skull ; 

One  frontal  bone,  whose  vertical  portion  forms 
the  forehead,  while  its  horizontal  portion  enters 
into  the  formation  of  the  roof  of  the  cavities  of 
the  eyes  (the  orbits)  and  of  the  nose ; 

Two  temporal  bones,  forming  the  temples  and 
containing  the  inner  ear  ; 

One  sphenoid  bone,  situated  at  the  base  of  the 
skull,  and  joining  with  all  the  other  bones  of  the 
cranium  and  some  of  the  face  ;  and 

One  ethmoid  bone,  situated  at  the  root  of  the 
nose,  and  entering  into  the  formation  of  the  cavi- 
ties of  the  skull,  the  eyes,  and  the  nose. 

The  cranial  bones  are  joined  to  their  neighbors 


4      THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

by  means  of  dovetailed,  toothed,  or  bevelled 
edges.  The  lines  of  junction  are  known  as  su- 
tures (seams). 

There  are  a  number  of  openings  in  the  cranial 
bones  through  which  blood-vessels  and  nervous 
structures  pass  into  or  out  of  the  cranial  cavity. 

The  Face  is  formed  of  fourteen  bones,  viz.: 

Two  nasal  bones,  forming  the  bridge  of  the  nose  ; 

Two  superior  maxillary  bones  (upper  jaw-bones) ; 

One  inferior  maxillary  bone  (lower  jaw-bone) ; 

Two  malar  (cheek)  bones ; 

Two  palate  bones  ; 

One  vomer,  forming  a  portion  of  the  partition 
of  the  nose ; 

Two  lachrymal  bones,  forming  part  of  the  inner 
wall  of  the  orbit  or  cavity  of  the  eye  ;  and 

Two  turbinated  bones,  situated  in  the  nasal 
cavities. 

Situated  above  the  Adam's  apple,  and  con- 
nected by  muscles  to  some  of  the  bones  of  the 
skull,  is  the  hyoid  bone,  which  may  well  be  men- 
tioned with  them. 

The  bones  of  the  face  enter  into  the  formation 
of  the  cavities  of  the  eye,  nose,  and  mouth. 

The  teeth  are  sometimes  classed  as  bones. 
They  are  thirty-two  in  number  in  the  adult,  viz., 
four  cutters  or  incisors,  two  canine  (so  called  on 
account  of  their  resemblance  to  a  dog's  teeth), 
and  ten  grinders  (four  false  molars,  six  true 
molars)  in  each  jaw. 


THE   HUMAN   BODY. 


THE  TRUNK. 

The  Trunk  comprises  the  spinal  column,  the 
thorax,  and  the  pelvis. 

The  Spinal  Column,  or  back-bone,  consists  of 
twenty-four  bones,  known  as  vertebra,  each  of 
which  is  formed  of  a  body  and  of  certain  off- 
shoots from  that  body.  The  body  and  its  off- 
shoots enclose  a  round  opening.  In  the  natural 
arrangement  in  column  of  the  vertebrae,  these 
openings  form  a  long  canal,  the  spinal  canal, 
which  contains  the  spinal  cord,  and  communi- 
cates with  the  cranial  cavity,  or  cavity  of  the 
skull,  through  the  large  opening  in  the  occipital 
bone  previously  referred  to. 

The  vertebrae  are  connected  by  tendon-like 
substances  permitting  of  a  bending  and  a  twist- 
ing of  the  back-bone.  They  are  divided  into — 

Seven  cervical,  situated  in  the  neck ; 

Twelve  dorsal,  situated  at  the  back  of  the 
chest ; 

Five  lumbar,  situated  in  the  region  of  the  loins. 

The  cervical  vertebrae  are  the  smallest,  the 
lumbar  the  largest.  The  vertebrae  in  general 
resemble  one  another  in  shape,  with  the  excep- 
tion of  the  upper  two  cervical,  which  are  modi- 
fied to  form  joints  for  movements  of  the  head. 

The  Thorax,  or  chest,  is  composed  of  the  ster- 
num, or  breast-bone,  and  the  ribs. 

The  sternum  is  a  flat,  narrow  bone,  situated  in 
the  middle  line  in  front  of  the  chest,  In  shape  it 


6      THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

somewhat  resembles  the  old  Roman  sword ;  it  is 
broad  above  and  pointed  below. 

The  ribs  are  twenty-four  in  number,  twelve  on 
each  side.  'They  are  elastic  arches  of  bone,  and 
are  joined  behind  to  the  dorsal  vertebrae.  In 
front  seven  pairs  are  joined  to  the  sternum  by 
means  of  the  costal  cartilages  ;  these  are  the  true, 
while  the  other  five  pair  are  the  false  ribs.  In 
front  the  upper  three  pair  of  false  ribs  are 
•  attached  by  their  cartilages  to  the  cartilages  of 
the  true  ribs  ;  the  lower  two  pair  having  the  front 
ends  free  are  called  floating  ribs.  Cartilage  is 
popularly  known  as  gristle. 

The  Pelvis  {pelvis,  a  basin)  forms  the  lowest 
portion  of  the  trunk,  and  is  composed  of  the  two 
hip-bones,  the  sacrum,  and  the  coccyx.  The  hip- 
bones are  flat  bones  lying  in  front  and  on  the 
sides  of  the  pelvis.  On  the  outer  side  of  each 
hip-bone  is  a  cup-shaped  depression  for  the  head 
of  the  thigh-bone.  The  sacrum  is  situated  at  the 
back  of  the  pelvis,  and  is  joined  to  the  last  ver- 
tebrae and  the  hip-bones.  The  coccyx  joins  the 
lower  portion  of  the  sacrum. 

^te  pelvic  cavity  is  continuous~with  the  abdom- 
inal, which  is  formed  by  the  five  lumbar  verte- 
brae, and  certain  soft  parts. 

THE  LIMBS. 

The  Limbs  are  divided  into  an  upper  and  a  lower 
pair. 

The  Upper  Limb  consists  of  the  shoulder,  arm, 
forearm,  and  hand. 


THE   HUMAN   BODY.  ^ 

The  Shoulder  consists  of  the  clavicle,  or  collar- 
bone,  and  the  scapula,  or  shoulder-Hade.  The 
former  is  a  bone  shaped  somewhat  like  the  italic 
letter/,  and  joins  with  the  sternum  and  the  scap- 
ula. The  scapula  is  a  flat,  triangular  bone,  which 
articulates  (joins)  with  the  humerus  to  form  the 
shoulder-joint. 

The  arm  consists  of  one  long  bone,  the  hum- 
erus. 

The  fore-arm  consists  of  two  long  bones,  the 
ulna  and  the  radius,  the  former  situated  on  the 
little  finger  side  of  the  arm  and  entering  into  the 
formation  of  the  elbow-joint,  the  latter  situated 
on  the  thumb  side  and  forming  a  large  part  of 
the  wrist-joint. 

The  hand  is  composed  of  the  carpus,  or  wrist 
(formed  of  eight  short  bones),  the  metacarpus,  or 
part  between  the  wrist  and  the  fingers  (five  small 
long  bones),  and  the  fingers  (fourteen  small  long 
bones,  three  to  each  finger,  with  the  exception  of 
the  thumb,  which  has  two). 

The  Lower  Limb  consists  of  the  thigh,  the  leg, 
and  the /<?<?/. 

The  thigh  consists  of  one  long  bone,  the  femur, 
or  thigh-bone,  whose  upper  end,  called  the  head, 
fits  into  the  cup-shaped  receptacle  of  the  hip- 
bone. 

The  leg  consists  of  two  long  bones :  the  inner 
and  stronger  one  is  called  the  tibia  (shin-bone), 
and  the  outer  and  weaker  one  \hzfibula.  Their 
lower  ends  form  the  ankles. 


8      THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

Between  the  thigh  and  leg,  in  front,  is  situated 
\ht  patett&i  or  knee-pan,  a  round,  flat  bone. 

The  foot  consists  of  the  tarsus,  which  corre- 
sponds to  the  wrist,  the  metatarsus,  and  the  toes. 
The  tarsus  consists  of  seven  short  bones,  the 
largest  of  which  is  the  os-calcis  (heel-bone),  to 
which  the  prominent  tendon  of  the  back  leg  is 
attached.  The  metatarsus  and  the  toes  are  simi- 
lar in  structure  to  the  metacarpus  and  the  fingers, 
and  contain  five  and  fourteen  bones,  respectively. 

THE  JOINTS. 

The  various  bones  of  the  body  are  held  to- 
gether at  different  parts  of  their  surfaces,  the  con- 
nections being  known  as  joints  or  articulations. 
Joints  may  be  classed  as  immovable,  slightly  mova- 
ble, and  f ~reely  movable.  The  joints  of  the  cranial 
bones,  for  example,  are  immovable,  those  of  the 
spine  in  general,  slightly  movable,  the  knee  and 
elbow  are  freely  movable.  The  parts  forming  a 
freely  movable  joint  are  the  ends  of  the  bones,  the 
cartilages,  or  gristly  substances,  covering  these 
ends,  the  ligaments,  or  bands  which  hold  them  to- 
gether and  form  a  capsule  or  sac  around  the  joint, 
and  a  synovial  membrane  lining  the  interior  of 
the  joint  and  secreting  a  thick  lubricating 
fluid.  Among  the  subdivisions  of  the  movable 
joint  are  the  gliding-joint,  as  the  one  between 
breast-bone  and  collar-bone,  the  hinge-joint,  as 
exemplified  in  the  elbow  and  knee,  and  the  ball 
and  socket  joint,  of  which  the  shoulder-joint  and 
hip  are  types. 


THE  HUMAN   BODY. 


THE  SOFT  PARTS. 

The  Muscles  constitute  the  bulk  of  the  soft 
portions  of  the  body.  Their  function  is  by  con- 
tracting to  move  the  parts  into  which  they  are 
inserted.  They  may  be  classed  as  voluntary  or 
involuntary,  according  as  they  are  or  are  not 
under  control  of  the  will.  The  muscles  of  the 
arm  are  examples  of  the  voluntary,  those  of  the 
bowels  of  involuntary,  muscles.  Contraction  is 
brought  about  by  an  impulse  originating  in  the 
brain  and  communicated  to  the  muscle  by  means 
of  a  nerve.  Voluntary  muscles,  as  a  rule,  origi- 
nate from  and  are  inserted  into  bone.  The  origin 
is  the  more  fixed  end,  the  insertion  the  movable 
point  to  which  the  muscular  power  is  applied. 
The  origin,  however,  is  absolutely  fixed  only  in  a 
few  muscles,  such  as  those  of  the  face,  which 
originate  from  bone  and  are  inserted  into  mova- 
ble skin  ;  in  the  greater  number  of  cases  the  mus- 
cle may  be  made  to  act  from  either  end. 

Fatty  Tissue  constitutes  another  of  the  soft 
parts.  It  is  widely  distributed,  imparting  a  ro- 
tund fulness  to  the  form,  preventing  a  too  rapid 
dissipation  of  bodily  heat,  protecting  the  internal 
organs  against  cold,  and  lessening  the  effects  of 
shock  and  pressure  upon  the  external  parts. 

Connective  Tissue  is  distributed  throughout 
the  body  for  the  purpose  of  holding  in  position 
the  component  structures. 

The  Skin  is   the   outermost   covering  of  the 


IO      THE   SOLDIER  S   FIRST  AID   HANDBOOK. 

body.  It  is  the  principal  seat  of  the  sense  of 
touch,  and  serves  as  a  protection  for  the  deeper 
tissues.  It  is  composed  of  an  outer  layer,  the 
scarf-skin,  and  an  inner  layer,  the  true  skin.  The 
nails  are  a  modification  of  the  scarf-skin.  Con- 
nected with  the  true  skin  are  the  sweat-glands, 
the  hair -follicles,  and  glands  secreting  an  oily 
material.  Imbedded  in  the  true  skin  are  innu- 
merable small  blood-vessels  and  fine  nerves.  The 
skin  is  very  absorbent. 

Among  the  remaining  soft  parts  are  the  blood- 
vessels, the  lymphatic  vessels  which  carry  nutri- 
tive fluid  from  the  intestines  and  elsewhere  into 
the  circulation,  the  nerves,  and  a  number  of 
organs  which  will  be  considered  hereafter. 

ORGANS  OF  THE  CRANIAL  AND  THE 
SPINAL  CAVITY. 

The  cavity  of  the  skull  contains  the  brain,  the 
membranes  covering  it,  and  the  nerves  connected 
with  it.  The  lower  and  posterior  part  of  the 
brain  joins  with  the  spinal  cord  through  the  large 
opening  in  the  base  of  the  skull.  The  nerves 
arising  directly  from  the  brain  are  called  cranial 
nerves,  and  are  twelve  in  number.  They  are 
principally  distributed  to  the  region  of  the  head. 
The  spinal  canal  contains  the  spinal  cord,  its  mem- 
branes, and  the  thirty-one  pairs  of  so-called  spinal 
nerves  given  off  at  regular  intervals  at  each  side 
of  the  column. 

The  Brain  is  endowed  with  a  number  of  facul- 


THE  HUMAN  BODY.  II 

ties,  among  which  may  be  mentioned  the  faculty 
of  perception,  the  intelligence,  and  the  will.  In 
the  brain  originate  the  impulses  governing  volun- 
tary motion.  This  organ  also  exercises  control 
over  many  of  the  bodily  functions  which  need  not 
be  specified  here. 

The  Spinal  Cord  is  a  continuation  of  the  brain. 
It  sends  nerves  to  the  muscles  and  integuments 
(coverings)  of  the  trunk  and  limbs.  It  acts  as  an 
organ  of  communication  between  the  brain  and 
the  external  parts,  but  has  special  functions  of 
its  own  in  addition. 

The  brain  and  spinal  cord  together  are  known 
as  the  cerebro-spinal  axis,  and  a  nerve  originating 
from  this  axis  is  called  a  cerebro-spinal  nerve. 
There  are  the  nerves  concerned  with  nutrition, 
growth,  etc.,  known  as  sympathetic  nerves,  whose 
consideration,  however,  does  not  come  within  the 
scope  of  this  manual. 

Cerebro-Spinal  Nerves  are  a  series  of  rounded 
cords  arising  from  the  cerebro-spinal  axis,  and  dis- 
tributed to  all  portions  of  the  body.  As  before 
mentioned,  those  arising  directly  from  the  brain 
are  called  cranial  nerves,  those  arising  from  the 
spinal  cord,  spinal  nerves.  It  must  be  remem- 
bered, however,  that  even  the  latter  are  ultimately 
connected  with  the  brain. 

Nerves  may  be  divided  into  sensory  and  motor, 
or  nerves  of  sensation  and  nerves  of  motion.  The 
former  convey  sensations  to  the  brain,  the  latter 
carry  from  brain  to  muscle  the  impulses  under 
which  muscular  contraction  is  produced. 


12     THE  SOLDIER  S   FIRST  AID  HANDBOOK. 

The  cranial  nerves  include  those  of  smell,  sight, 
hearing,  taste,  one  nerve  of  touch,  and  several 
motor  nerves. 

The  spinal  nerves  give  off  both  sensory  and 
motor  branches. 

THE  ORGANS  OF  THE  LESSER  CAVI- 
TIES OF  THE  HEAD. 

The  lesser  cavities  of  the  head  are  the  orbits 
containing  the  eyes,  the  nasal  cavities,  containing 
the  apparatus  of  smell,  the  cavity  of  the  mouth, 
containing  the  organ  of  taste,  and  the  cavity  of 
the  internal  ear. 

THE  ORGANS  OF  THE   THORACIC 
CAVITY. 

The  thoracic  cavity  or  chest  is  one  of  the  large 
cavities  of  the  trunk,  the  other  two  being  the  ab- 
dominal and  the  pelvic  cavity.  The  chest  is  sepa- 
rated from  the  belly  by  a  muscular  partition 
called  the  diaphragm  (midriff). 

The  heart  and  lungs  occupy  the  larger  portion 
of  the  chest,  which  further  contains  a  part  of  the 
wind-pipe  and  gullet,  the  large  blood-vessels,  and 
the  pleura. 

The  Lungs  are  divided  into  a  right  and  left 
lung.  The  right  has  three  lobes,  the  left  two. 
One  layer  of  a  membraneous  sac  called  the  pleura 
covers  each  lung,  the  other  layer  lines  the  adja- 
cent portion  of  the  interior  of  the  chest. 


THE  HUMAN  BODY.  13 

The  lungs  are  the  main  organs  of  respiration 
or  breathing.  An  adult  breathes  ordinarily  about 
twenty  times  a  minute.  On  inspiration,  fresh  air 
is  drawn  into  the  lungs,  and  is  taken  up  by  count- 
less numbers  of  minute  blood-vessels  distributed 
through  their  substance,  the  blood  thus  obtaining 
the  pure  oxygen  it  needs.  On  expiration  the 
impure  gases  which  the  blood  gives  off  are  ex- 
pelled. Air  reaches  the  lungs  through  the  mouth 
or  nosey  the  larynx,  which  projects  in  front  of  the 
neck  as  the  Adam's  apple,  the  trachea,  or  wind- 
pipe, and  the  bronchial  tubes.  The  main  bronchial 
tubes  are  two  in  number,  one  for  each  lung.  The 
right  tube  subdivides  into  three,  the  left  one  into 
two  branches,  to  supply  the  five  lobes.  This  sub- 
division continues  until  the  smallest  tubes  are 
reduced  in  diameter  to  from  one-fiftieth  to  one- 
thirtieth  of  an  inch. 

The  Heart  lies  behind  the  lower  two-thirds  of 
the  sternum,  or  breast-bone,  and  projects  farther 
into  the  left  than  into  the  right  side  of  the  chest. 
It  is  five  inches  in  length,  three  and  one-half  inches 
in  width  at  the  broadest  part,  and  two  and  one- 
half  inches  in  thickness.  The  widest  portion  is 
uppermost ;  the  point,  or  apex,  is  downward,  and 
may  be  felt  beating  between  the  fifth  and  sixth 
rib  on  the  left  side.  By  a  vertical  partition  the 
heart  is  divided  into  halves,  called  respectively 
the  right  and  the  left;  a  horizontal  partition 
divides  each  half  into  two  cavities,  the  upper  ones 
called  the  auricles,  the  lower  the  ventricles.  The 
auricle  of  each  side  opens  into  the  ventricle  of  the 


14    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

same  side,  the  opening  being  guarded  by  a 
valve. 

From  the  left  ventricle  arises  the  main  artery 
of  the  body,  the  aorta.  By  an  artery  is  meant  a 
vessel  which  carries  blood  away  from  the  heart, 
by  a  vein  one  which  carries  blood  towards  it. 
Capillaries  are  the  minute  vessels  intermediate 
between  the  smallest  arteries  and  the  smallest 
veins.  The  aorta  gives  off  branches  which  divide 
and  subdivide  until  the  capillaries  are  reached. 
These  unite  to  form  small  veins,  which  joining 
together,  form  larger  and  larger  vessels,  these 
finally  opening  into  the  right  auricle. 

The  heart  is  mainly  composed  of  muscle,  and 
may  be  regarded  as  a  muscular  force-pump. 
When  it  contracts,  it  forces  blood  from  the 
ventricle  successively  into  the  aorta,  the  lesser  ar- 
teries, the  capillaries,  the  veins,  and  into  the  right 
auricle.  This  course  of  the  blood  constitutes  the 
systemic  circulation,  or  the  circulation  through 
the  body  at  large. 

The  blood  which  left  the  left  heart  pure  has  in 
its  course  taken  up  noxious  gases,  which  must  be 
given  off  in  the  lungs  in  exchange  for  the  oxy- 
gen of  the  air.  Hence  the  blood  reaching  the 
right  auricle  passes  into  the  right  ventricle,  and 
is  pumped  through  the  lungs  by  a  contraction 
of  the  right  ventricle.  In  the  lungs  it  courses 
through  the  pulmonary  arteries,  the  pulmonary 
capillaries,  and  the  pulmonary  veins,  reaching  the 
left  auricle  and  finally  the  left  ventricle  in  a  puri- 


THE  HUMAN  BODY.  15 

fied  condition.  This  is  the  pulmonary  circula- 
tion or  circulation  through  the  lungs. 

When  an  artery  of  the  systematic  circulation  is 
cut,  the  blood  issues  in  spirts,  and  is  of  a  bright- 
red  color  ;  venous  blood  flows  in  a  steady  stream 
and  is  dark  red ;  in  capillary  hemorrhage  the 
blood  oozes  out,  and  is  of  an  intermediate  shade. 

When  the  finger  is  laid  upon  a  superficial  artery 
a  series  of  shocks  is  perceived  known  as  the  pulse, 
and  due  to  the  contractions  of  the  heart  acting 
upon  the  column  of  blood.  The  pulse-rate  or- 
dinarily in  the  adult  is  seventy ;  that  is  to  say,  his 
heart  beats  that  number  of  times  in  a  minute. 

As  connected  in  a  measure  with  the  subject  of 
circulation,  it  is  to  be  noted  that  the  normal  tem- 
perature of  tJie  human  body  as  registered  under  the 
tongue  is  ninety-eight  and  nine-tenths  degrees 
(98.9°)  F. 

THE   ORGANS   OF    THE    ABDOMINAL 
AND  PELVIC  CAVITIES. 

The  abdominal  cavity  contains  the  following 
organs :  the  stomach,  the  intestines  or  bowels,  the 
liver,  the  pancreas,  the  spleen,  the  kidneys,  and  the 
peritoneum,  or  membrane  covering  the  bowels. 
It  is  separated  from  the  cavity  of  the  thorax  by 
the  diaphragm.  The  pelvic  cavity  is  continuous 
with  the  abdominal,  and  contains  the  bladder  and 
its  appendages,  a  portion  of  the  generative  appara- 
tus, and  the  lower  end  of  the  bowels. 

The  Stomach  is  the  principal  organ  of  diges- 


16    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

tion.  It  resembles  a  sack  in  shape,  and  is  situated 
immediately  behind  the  anterior  wall  of  the  ab- 
domen below  the  liver  and  the  diaphragm.  When 
moderately  full,  its  horizontal  diameter  measures 
about  twelve  inches,  its  vertical  about  four.  It 
has  two  openings,  one  on  the  left  side  for  the 
gullet,  or  food  passage  connecting  the  stomach 
with  the  mouth,  and  one  on  the  right  for  the 
bowel.  The  stomach  secretes  gastric  juice,  which 
is  one  of  the  digestive  fluids. 

The  Intestines  are  divided  into  the  small and 
large  intestine.  The  small  intestine,  about  twenty 
feet  in  length,  begins  at  the  stomach  and  ends  in 
the  large  intestine.  The  large  intestine  is  about 
five  feet  in  length,  and  extends  from  the  small 
intestine  to  the  external  opening  of  the  bowels, 
the  anus.  It  lowest  portion  is  called  the  rectum. 

The  Liver  lies  mainly  upon  the  right  side  of 
the  abdominal  cavity  under  the  diaphragm.  It  is 
composed  of  two  lobes, — a  larger,  the  right  lobe, 
and  a  smaller,  the  left  lobe.  The  main  function 
of  the  liver  is  to  extract  from  the  blood  the  sub- 
stances forming  bile ;  besides  this,  it  also  brings 
about  certain  changes  in  the  constituents  of  the 
circulatory  fluid.  The  biliary  substances  are  of 
two  classes,  viz.,  such  as  are  of  further  use  in  the 
system,  namely,  in  the  process  of  digestion,  and 
those  which  have  been  extracted  from  the  blood 
as  impurities,  and  are  hence  to  be  discharged 
from  the  body  as  valueless.  Bile  is  stored  in  the 
gall-bladder,  from  which  it  is  conducted  into  the 
intestine  through  a  tube,  the  bile-duct. 


THE   HUMAN   BODY.  IJ 

The  Pancreas  lies  behind  the  stomach.  It 
secretes  a  fluid  which  assists  in  the  process  of 
digestion. 

Organs  which,  like  the  liver  and  pancreas,  have 
the  faculty  of  extracting  certain  substances  from 
the  blood  and  elaborating  them  into  fluids  des- 
tined for  various  purposes,  are  called  glands.  The 
fluids  formed  are  called  secretions,  if  they  are  to 
be  further  utilized  in  the  body,  and  excretions,  if 
they  are  impurities  and  destined  to  be  cast  off. 

The  Spleen  lies  on  the  left  side  of  the  abdominal 
cavity,  opposite  the  liver.  Its  functions  are  con- 
cerned in  the  elaborations  of  the  blood. 

The  Kidneys  are  the  two  glands  lying  one  on 
each  side  of  the  spinal  column.  They  are  about 
four  inches  in  length,  and  bean-shaped.  Their 
function  is  to  separate  from  the  blood  certain  sub- 
stances, which,  when  dissolved  in  water  likewise 
withdrawn  from  the  circulatory  fluid,  constitute 
the  urine.  The  daily  quantity  of  this  excretion 
is  from  forty  to  sixty  ounces  (about  a  quart  and 
a  quarter  to  two  quarts). 

The  Ureters  are  the  two  tubes  which  conduct 
the  urine  from  the  kidneys  to  the  bladder. 

The  Bladder  is  situated  in  the  pelvic  cavity  and 
is  a  receptacle  for  the  urine. 

The  Urethra  is  the  tube  which  discharges  the 
urine  from  the  bladder.  For  a  part  of  its  course 
it  runs  through  the  male  organ,  the  penis. 

The  Seminal  Vesicles,  or  sacs  containing  the 
seminal  fluid,  lie  underneath  the  bladder.  They 


1 8    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

store  the  semen  formed  in  the  testicles,  discharg- 
ing it  through  small  ducts  into  the  urethra. 

The  Peritoneum  is  a  membranous  sac  one  layer 
of  which  covers  the  abdominal  organs  and  some 
of  the  pelvic,  while  the  other  layer  lines  the  in- 
terior of  the  walls  of  the  belly.  It  forms  a  num- 
ber of  ligaments,  or  bands,  which  hold  the  organs 
in  place,  and  secretes  a  lubricating  fluid  called 
serum. 

The  abdominal  and  pelvic  cavities  together  are 
known  popularly  as  the  belly. 


LOCATION  OF   THE  PRINCIPAL 
BLOOD-VESSELS. 

One  of  the  most  important  anatomical  points 
with  which  it  is  necessary  that  the  bearer  should 
be  familiar  is  the  location  of  the  large  arteries. 
Especially  should  he  know  where  the  vessels  are 
superficial,  that  is  to  say,  almost  immediately 
under  the  skin. 

Thex  Aorta  is  the  main  vessel  of  the  systemic 
circulation.  It  arises  from  the  left  ventricle,  as- 
cends for  a  short  distance  behind  the  breast-bone, 
then  forming  its  arch,  reaches  the  spinal  column, 
and  descends  within  the  chest  and  abdomen,  on 
the  left  side  of  the  spine,  dividing  at  the  level  of 
the  fourth  lumbar  vertebra.  The  arch  gives  off 
arteries  whose  branches  supply  the  head  and 
upper  limbs,  while  the  descending  portion  fur- 
nishes vessels  to  the  trunk  and  its  organs,  and  on 


THE   HUMAN   BODY.  19 

dividing  gives  off  a  large  artery  to  each  of  the 
lower  limbs. 

The  arterial  trunks  supplying  the  head  ascend, 
one  on  each  side  of  the  windpipe,  and  are  super- 
ficial along  the  edge  of  the  diagonal  muscles, 
which  are  prominently  seen  when  the  head  is 
turned  to  one  side  or  the  other.  They  are  known 
as  the  carotids. 

The  arterial  trunk  supplying  the  upper  limb 
emerges  from  the  chest  over  the  first  rib,  and 
passing  under  the  middle  of  the  collar-bone,  runs 
through  the  axilla  or  arm-pit,  and  along  the  inner 
side  of  the  arm  between  the  two  prominent  mus- 
cles, the  biceps  and  the  triceps.  At  the  middle 
of  the  front  of  the  elbow  it  divides  into  two  prin- 
cipal branches  for  the  fore-arm.  It  is  superficial 
in  the  hollow  behind  the  collar-bone,  at  the  apex 
and  outer  side  of  the  arm-pit,  in  the  groove  be- 
tween the  biceps  and  triceps,  and  in  front  of  the 
elbow. 

The  two  principal  branches  for  the  fore-arm 
pass  down,  one,  the  radial,  on  the  thumb  (outer) 
side,  and  the  other,  the  ulnar,  on  the  little  finger 
(inner)  side  of  the  limb.  In  the  palm  they  form 
a  loop,  the  palmar  arch,  which  gives  off  branches 
to  the  fingers.  The  radial  is  superficial  through- 
out its  entire  extent,  and  may  be  felt  beating  at 
the  outer  side  of  the  outer  of  the  two  tendons, 
which  are  prominent  in  front  of  the  middle  of  the 
wrist.  The  radial  artery  at  the  wrist  is  generally 
felt  for  the  pulse.  The  ulnar  is  deeply  situated  for 
the  greater  part  of  its  course,  but  at  the  wrist  it 


2O     THE   SOLDIER  S   FIRST  AID   HANDBOOK. 

is  superficial,  and  located  about  half  an  inch  to 
the  inner  side  of  the  inner  of  the  two  prominent 
tendons  mentioned. 

The  arterial  trunk  supplying  the  lower  limb 
arises  from  the  termination  of  the  aorta  near  the 
end  of  the  back-bone,  and  passes  out  through  the 
groin  to  the  front  of  the  thigh  at  about  two- 
thirds  the  distance  from  the  hip-bone  to  the 
middle  line  of  the  body.  Descending  between 
the  muscles  on  the  inner  side  of  the  thigh,  it 
reaches  the  middle  of  the  hollow  at  the  back  of 
the  knee,  subsequently  dividing  into  three  princi- 
pal branches  for  the  leg.  It  is  superficial  for 
several  inches  from  the  groin  down,  and  again  in 
the  middle  of  the  hollow  of  the  knee. 

The  principal  arterial  branches  for  the  leg  are 
three.  One  passes  forward  through  the  space  be- 
tween the  tibia  and  fibula,  and  descends  between 
the  muscles  of  the  leg,  becoming  superficial  in 
front  of  the  middle  of  the  ankle  joint.  The  other 
two  branches  are  deeply  situated  in  the  back  of 
the  leg,  one  on  each  side,  becoming  superficial 
behind  the  inner  and  outer  ankle,  respectively. 
They  supply  the  sides  and  sole  of  the  foot,  and 
in  the  sole  unite  in  a  loop,  the  plantar  arch,  from 
which  branches  are  distributed  to  the  toes. 

The  veins  generally  follow  the  course  of  the 
arteries.  There  are  a  number  of  them,  however, 
which  are  not,  so  to  speak,  mated  with  arteries. 


FIRST   AID   ON  THE   BATTLE-FIELD.  21 


PART  II. 

FIRST  AID  ON  THE  BATTLE-FIELD. 

Besides  carrying  out  instructions  concerning 
cases  which  the  surgeon  has  already  treated,  the 
bearer,  independently,  will  frequently  be  called 
upon  to  administer  first  aid  to  his  disabled  com- 
rades. Especially  is  this  the  case  in  time  of 
war,  and  hence  it  is  meet  that  the  management 
of  those  wounded  in  battle  should  be  first  con- 
sidered. 

GENERAL   MANAGEMENT  OF    MEN 
WOUNDED  IN  BATTLE. 

In  the  absence  of  anything  demanding  prior 
attention,  the  bearers  on  reaching  a  wounded 
comrade  should  first  of  all  contribute  to  his  com- 
fort by  opening  tight  garments  and  removing  en- 
cumbering accoutrements.  The  rifle  or  carbine 
should  be  unloaded,  not  discharged.  While  one 
or  two  bearers  are  accomplishing  these  things,  a 
third  administers  water  or  necessary  stimulant, 
while  a  fourth  busies  himself  with  examining  the 
wound.  In  order  to  obtain  a  view  of  the  injury, 
it  may  be  necessary  to  cut  the  investing  clothes 
along  the  seam,  or  to  remove  the  garment. 
When  the  latter  is  done,  it  is  to  be  remembered 


22    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

that  the  injured  part  is  the  last  to  be  unclothed, 
while  it  is  the  first  to  be  clothed  when  the  gar- 
ment is  replaced.  The  wound  having  received 
proper  attention,  the  severely  injured  patient  is 
carried  from  the  field  to  the  so-called  dressing  sta- 
tion, distinguishable  by  the  red-cross  guidon  or  a 
lantern.  Here  a  complete  examination  is  made 
by  the  surgeon,  food  is  given,  and  a  classification 
of  cases  effected,  prior  to  their  transfer,  if  neces- 
sary, to  the  field  hospital. 


POSITION  OF   THE  WOUNDED   UPON 
THE  LITTER. 

When  a  patient  is  carried  upon  a  litter  he 
should  be  made  as  comfortable  as  possible, 
strained  and  painful  positions  being  avoided.  For 
the  purpose  of  bolstering  him  up,  pillows,  blank- 
ets, various  available  articles  of  clothing,  knap- 
sacks, bundles  of  hay,  etc.,  may  be  used.  Frac- 
tured limbs  must  be  securely  steadied,  either  by 
the  application  of  temporary  splints,  etc.,  or  by 
being  appropriately  propped  up.  In  hemorrhage 
from  the  great  cavities  the  body  should  be  inclined 
towards  the  bleeding  wound.  Unconsciousness  re- 
sulting from  faintness  requires  that  the  head  should 
be  kept  low,  but  when  it  is  due  to  a  blow  upon  the 
skull,  the  head  should  be  raised.  An  extemporary 
pillow  with  side  cushions  may  be  made  by  folding 
a  blanket  or  overcoat  to  the  desired  width,  roll- 
ing it  from  both  ends,  and  after  proper  adjust- 


POSITION  OF  WOUNDED   UPON   LITTER.       23 

ment,  securing  it  in  position  by  a  bandage,  hand- 
kerchief, or  neck-tie.  It  is  especially  useful  in 
wounds  of  the  head  and  face.  Gaping  wounds  of 
the  front  of  the  neck  require  that  the  head  be  well 
raised  and  bent  forward  upon  the  chest.  Penetrat- 
ing wounds  involving  the  lung  frequently  cause 
great  distress  in  breathing,  which  the  bearers  must 
seek  to  remedy  by  tucking  a  folded  blanket,  over- 
coat, blouse,  under  the  raised  chest.  In  penetrating 
wounds  of  the  abdomen,  in  general,  the  patient  is 
placed  upon  his  back  if  the  wound  is  in  front, 
and  upon  the  injured  side  if  lateral.  In  both 
cases  the  legs  should  be  drawn  up,  and  in  the 
first  instance  the  shoulders  raised.  A  horizontal 
slash  across  the  belly  requires  the  sitting  pos- 
ture, a  vertical  one  the  recumbent.  In  wounds 
of  the  upper  arm  the  patient  is  laid  upon  his 
back,  the  injured  extremity  evenly  and  comfort- 
ably supported,  and  resting  alongside  the  body. 
In  injuries  of  the  fore-arm,  wrist,  or  hand  the 
wounded  member  is  best  laid  across  the  chest  or 
abdomen,  with  the  elbow  propped  up,  and  the 
arm,  if  practicable,  bound  to  the  body.  In  inju- 
ries of  the  lower  extremities  the  patient  is  laid 
upon  his  back  and  the  member  securely  propped  ; 
in  case  of  fracture  of  one  limb,  the  other  limb 
should  be  utilized  as  a  splint,  the  wounded  one 
being  tied  to  it.  Improvised  splints  may  be  ap- 
plied if  the  patient  is  to  be  transported  for  a  long 
*  distance. 


24    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 


LIMITATION  OF  THE  DUTIES  OF 
BEARERS. 

The  bearers  should  be  careful  never  to  exceed 
their  duties  by  endeavoring  to  afford  treatment 
that  had  better  be  applied  by  the  surgeon,  but 
should  strive  to  place  the  wounded  man  under 
that  officer's  care  as  soon  as  practicable. 

THE  BEARER'S  EQUIPMENT. 

Pursuant  to  regulations,  each  member  of  the 
Hospital  Corps  and  each  company  bearer  in  the 
field  or  in  time  of  war,  carries  upon  his  person  a 
canteen  of  water,  a  knife  of  approved  pattern,  and 
a  simple  package  of  dressings  ;  one-fourth  of  the 
hospital  privates  carry  the  so-called  medicine-cases, 
containing  portable  drugs,  dressings,  restoratives, 
anaesthetics,  and  a  few  simple  instruments. 

The  package  of  dressings  carried  by  all  bear- 
ers, and  one  similar  to  which  is  in  certain  foreign 
armies  issued  to  every  soldier,  is  known  as  "  Es- 
marctis  First  Help  for  Wounds."  It  is  a  flat 
packet  about  four  inches  by  three  in  dimension, 
and  contains,  in  a  water-proof  wrapper,  two  anti- 
septic compresses  of  sublimated  gauze  in  oiled 
paper,  one  antiseptic  bandage  of  sublimated  cam- 
bric, one  Esmarch's  triangular  bandage  with  its 
mode  of  application  illustrated  upon  itself,  and 
two  safety-pins.  Printed  directions  upon  the 
wrapper  read  as  follows; 


THE   USE   OF   FIRST  AID   PACKETS.  2$ 

"  Place  one  of  the  compresses  on  the  wound, 
removing  the  oiled  paper.  In  case  of  large 
wounds  open  the  compress  and  cover  the  whole 
wound.  Apply  the  antiseptic  bandage  over  the 
compress.  Then  use  the  triangular  bandage  as 
shown  by  illustrations  on  the  same." 

In  order  that  he  may  be  able  to  properly 
dress  such  injuries  as  he  is  called  upon  to  attend, 
the  bearer  must  be  provided  with  appliances  to 
check  hemorrhage,  exert  pressure  upon  parts,  re- 
tain them  in  their  proper  position,  or  protect 
them  against  dirt.  Such  articles  include  lint, 
compresses,  roller  and  triangular  bandages,  splints, 
and  either  tourniquets  or  elastic  bandages. 

Lint  is  shredded  or  scraped  linen  used  to  cover 
wounds  and  to  arrest  slight  bleeding.  It  is  either 
applied  dry,  or  moistened  with  water,  oil,  vinegar, 
antiseptic  fluids,  etc.  Patent  lint  is  a  manufac- 
tured substitute  furnished  in  sheets.  Allied  to 
lint  are  styptic  cotton,  which  coagulates  or  clots 
blood,  absorbent  cotton,  antiseptic  cotton,  etc. 

A  compress  is  a  piece  of  linen  or  muslin  folded 
upon  itself  several  times,  retaining  the  lint  in 
place  and  serving  as  a  pad  to  exert  pressure. 

Roller  bandages  consist  of  rolled  strips  of  certain 
materials  of  various  lengths  and  breadths,  and  are 
applied  over  the  so-called  first  pieces  of  surgical 
dressing  which  are  in  immediate  contact  with  the 
wound.  They  are  generally  made  of  linen,  flan- 
nel, or  gauze.  A  roller  bandage  should  be  applied 
with  regularity,  so  that  the  pressure  exerted  may 
be  uniform.  It  should  be  neither  too  tight  nor 


26    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

too  loose,  and  when  employed  upon  an  extremity, 
should  be  made  to  ascend  the  limb. 

The  triangular  bandage  is  not  only  useful  as  a 
retentive  dressing,  but  also  as  a  sling.  Further- 
more, it  may  be  employed  in  the  form  of  the 
knotted  cloth,  or  of  the  Spanish  windlass,  to  be 
described  hereafter. 

Splints  are  made  of  wood,  paste-board,  leather, 
wire,  felt,  straw,  or  other  material,  and  are  used  to 
keep  fractured  limbs  in  a  fixed  position.  They 
may  be  improvised  from  a  number  of  articles 
available  on  the  battle-field,  such  as  rifles,  carbines, 
scabbards,  side-arms,  rolled  blankets,  pickets, 
shingles,  sticks,  twigs,  straw  mats,  etc.  Impro- 
vised splints  should  be  well  padded  to  conform 
with  the  curves  of  the  limb.  Splints  are  kept  in 
place  by  triangular  or  roller  bandages,  straps, 
cords,  etc.  Under  Fractures,  they  will  be  referred 
to  more  fully. 

The  tourniquet  and  the  elastic  bandage  are  used 
to  exert  pressure  upon  blood-vessels.  They  will 
be  further  considered  under  hemorrhages. 

It  will  be  noticed  that  the  Esmarctis  package 
contains  articles  subserving  the  purposes  of  all 
the  above  appliances,  splints  excepted. 

FIRST  AID  TREATMENT  OF  HEM- 
ORRHAGE. 

Upon  the  field  of  battle  the  casualties  claiming 
the  attention  of  the  bearer  will  mainly  be  wounds. 
Hemorrhage  or  bleeding  always  accompanies  these 


TREATMENT  OF   HEMORRHAGE.  2^ 

injuries,  and  as  a  necessary  preliminary  to  an  in- 
telligent management  of  them  a  knowledge  of 
its  first  aid  treatment  is  essential.  Serious  hem- 
orrhage is  an  accident,  in  the  treatment  of  which 
the  application  or  omission  of  a  few  simple  pro- 
cedures, easily  learned,  easily  remembered,  and 
readily  applied,  will  often  make  the  difference  of 
life  and  death  to  the  sufferer. 

The  mechanism  of  the  circulation  and  the  loca- 
tion of  the  principal  arteries  have  already  been 
considered. 

Hemorrhage,  as  stated,  is  of  three  kinds,  viz., 
in  the  order  of  gravity,  capillary,  venous,  and 
arterial. 


CAPILLARY  HEMORRHAGE. 

Capillary  Hemorrhage,  alone,  attends  every 
minor  cut.  The  blood  oozes  out  and  is  of  a  color 
intermediate  in  shade  between  that  of  arterial  and 
venous  blood.  The  flow  is  generally  inconsider- 
able, and  ordinarily  is  soon  arrested  by  the  expo- 
sure of  the  cut  to  the  air.  Elevation  of  the  parts 
and  pressure  upon  them  may  effect  the  same  re- 
sult, or  cold,  hot,  astringent,  or  styptic  (blood- 
clotting)  applications  may  be  employed.  Vinegar, 
alum,  and  tannin  are  astringents ;  Monsel's  solu- 
tion is  a  styptic.  Hot  applications,  such  as  a 
folded  cloth  soaked  in  as  hot  water  as  the  hand 
will  tolerate  and  lightly  wrung  out,  are  of  especial 
use  in  oozing  frprn  large  surface. 


28    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 


VENOUS  HEMORRHAGE. 

Venous  Hemorrhage  occurs  as  a  steady  flow, 
the  blood  being  of  a  dark  shade  of  red.  Gen- 
erally it  is  readily  controlled — when  slight,  even 
by  the  simple  application  of  cold,  or  when  severer, 
by  the  employment  of  pressure  above  and  below 
the  wound  in  the  vessel.  This  pressure  may  be 
made  by  applying  the  fingers  or  a  dry  pad  of 
cloth  firmly  bound  down  by  a  bandage,  or  in  some 
cases  both. 

ARTERIAL  HEMORRHAGE. 

Arterial  Hemorrhage  occurs  in  jets,  their  num- 
ber corresponding  to  the  number  of  heart-beats  in 
the  same  time.  The  blood  is  bright  red.  When 
the  largest  arteries  are  wounded,  the  resulting 
hemorrhage,  if  unchecked,  soon  causes  death  on 
account  of  the  great  amount  of  blood  lost.  In 
injuries  of  this  kind,  all  that  the  bearer  will  be 
able  to  do  will  be  to  thrust  his  finger  or  some 
other  plug  deeply  into  the  wound  and  to  endeavor 
by  firm  pressure  to  arrest  the  flow.  It  is  rarely 
that  he  will  succeed  in  his  purpose. 

As  arteries  carry  the  blood  away  from  the  heart, 
the  general  rule  to  be  observed  in  the  management 
of  arterial  hemorrhage  is  to  completely  obstruct  the 
artery  by  pressure  at  the  bleeding  point  or  between 
it  and  the  heart. 

Pressure  may  be  applied  by  the  fingers,  pad  or. 
plug  and  bandage,  knotted  cloth  or  handkerchief, 


TREATMENT  OF  ARTERIAL   HEMORRHAGE.   2Q 

Spanish  windlass,  tourniquet,  the  elastic  bandage, 
or  by  flexion  (bending)  of  an  extremity  so  that 
the  vessel  is  compressed  between  the  members. 

The  finger  is  applicable  in  all  cases ;  the  pad  and 
bandage  may  be  employed  in  bleeding  from  quite 
small  branches.  The  plug  consists  of  a  packing 
of  lint,  cotton  (styptic  or  otherwise),  old  muslin  or 
linen,  etc.,  thrust  into  a  wound  and  firmly  bound 
down  by  a  bandage.  In  using  the  knotted  hand- 
kerchief ,  the  knot  is  placed  at  the  proper  spot  over 
the  course  of  the  artery,  and  the  two  ends  of  the 
handkerchief  are  then  passed  around  the  limb  and 
firmly  tied.  The  Spanish  windlass  and  the  tour- 
niquet are  modifications  of  the  knotted  handker- 
chief. The  windlass  consists  of  a  cloth  into 
which  a  stone  or  other  hard  round  body  has  been 
folded.  The  stone  being  placed  at  the  proper 
spot  over  the  course  of  the  artery,  the  ends  of  the 
cloth  are  brought  around  the  limb  and  loosely  tied. 
A  stick  is  slipped  under  and  twisted,  until  the 
tightened  cloth,  through  the  stone  in  it,  causes 
just  enough  pressure  upon  the  vessel  to  stop  the 
bleeding.  In  order  to  avoid  pinching  of  the  skin 
under  the  stick,  a  pad  of  some  kind  may,  if  avail- 
able, be  interposed.  The  field  tourniquet  consists 
of  a  pad,  which  takes  the  place  of  the  knot  in  the 
handkerchief,  and  a  strap  and  buckle  to  hold  the 
pad  in  its  position  over  the  artery.  The  screw 
tourniquet,  in  addition,  is  furnished  with  two  plates, 
through  one  of  which  works  a  screw.  When  the 
instrument  has  been  adjusted  the  turning  of  the 
screw  tightens  the  strap  and  increases  the  pressure 


3o    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

exerted  by  the  pad  upon  the  artery.  Sometimes 
the  pad  is  wanting,  when  its  place  may  be  rilled  by 
a  roller.  The  elastic  bandage  is  a  roll  of  rubber 
band  about  three  inches  wide.  It  causes  consider- 
able pressure  by  virtue  of  its  elasticity.  It  is  ap- 
plied at  a  point  immediately  above  the  wound,  and 
is  made  to  spirally  ascend  the  member.  The  in- 
fluence of  flexion  of  a  limb  upon  the  arterial 
flow  in  the  vessels  below  the  joint  can  be  seen  by 
noting  the  cessation  of  the  radial  pulse  when  the 
forearm  is  forcibly  bent  upon  the  arm.  Flexion 
may  be  combined  with  the  use  of  the  knotted 
cloth. 

In  cases  of  hemorrhage  controlled  by  the  tour- 
niquet, windlass,  elastic  bandage,  or  knotted  hand- 
kerchief, the  surgeon's  services  should  be  procured 
as  soon  as  practicable,  otherwise  the  continuous 
pressure  exerted  will  work  injury  by  shutting  off 
the  circulation  from  the  limb  below. 

For  Hemorrhage  from  the  Artery  of  the 
Neck,  pressure  with  the  fingers  is  alone  indicated. 
It  is  applied  by  pushing  the  finger  deeply  into  the 
neck  in  a  backward  and  inward  direction  at  the 
anterior  border  of  the  prominent  neck  muscle. 

For  Hemorrhage  from  the  Artery  of  the  Arm 
in  its  Uppermost  Portion,  downward  pressure  is 
applied  behind  the  middle  of  the  collar-bone. 
Naturally  this  pressure  will  first  be  made  by  the 
thumb,  which  may  be  moved  towards  the  breast- 
bone or  towards  the  shoulder  if  it  fails  to  strike 
the  artery  at  once.  If  necessary,  the  thumb  may 
be  cautiously  replaced  by  a  finger-shaped,  nicely 


TREATMENT   OF  ARTERIAL   HEMORRHAGE.   31 

rounded  stone  or  stick,  or  a  rifle  cartridge,  etc., 
the  skin  being  protected  as  soon  as  practicable  by 
an  interposed  pad  of  lint,  linen,  or  bandage. 

For  Hemorrhage  from  the  Artery  of  the 
Arm  in  its  Lower  Portion,  pressure  by  the  thumb 
is  made  above  the  wound  and  upon  the  vessel's 
course  (i.e.,  along  the  inner  side  of  the  arm,  and 
in  the  line  of  division  between  the  two  prominent 
muscles),  the  arm  being  grasped  between  the 
thumb  and  fingers  of  the  bearer's  hand.  Subse- 
quently a  piece  of  cloth  tied  into  a  knot  as  big  as 
a  fist  may  be  pushed  well  up  into  the  armpit,  and 
the  arm  brought  down  and  bound  against  the  side 
of  the  chest ;  or  the  Spanish  windlass,  tourniquet, 
or  elastic  bandage  may  be  applied. 

For  Hemorrhage  from  Arteries  of  the  Fore- 
arm, pressure  by  the  fingers  on  the  artery  of  the 
arm,  made  as  above  detailed,  is  the  first  measure  to 
be  adopted.  A  knotted  handkerchief,  the  knot 
placed  over  the  middle  of  the  joint,  is  then  tightly 
tied  around  the  limb,  and  the  fore-arm  bent  so  as  to 
press  forcibly  against  the  knot.  The  main  blood- 
vessel situated  in  the  middle  line  over  the  elbow 
will  then  become  occluded.  Instead  of  the  knotted 
handkerchief,  the  elastic  bandage  may  be  used. 
It  is  applied  above  the  wound,  and  its  successive 
turns  are  made  to  ascend  the  arm. 

For  Hemorrhage  from  the  Arteries  of  the 
Hand,  pressure  is  made  with  the  fingers  upon  the 
bleeding  spot,  or  with  both  thumbs  on  the  arteries 
on  each  side  of  the  prominent  wrist  tendons, 
together  with  elevation  of  the  part.  Again  the 


32    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

bandage  and  pad  may  be  employed,  or,  if  necessary, 
the  measures  detailed  in  the  preceding  paragraph. 

For  Hemorrhage  from  the  Arteries  of  the 
Thigh,  pressure  by  the  thumbs,  the  ringers  grasp- 
ing each  side  of  the  limb,  is  the  first  measure  to 
adopt.  This  pressure  is  made  over  the  course  of 
the  artery  and  above  the  wound.  The  vessel  makes 
its  appearance  in  the  groin  at  about  two-thirds  the 
distance  from  the  hip-bone  to  the  central  line, 'and 
is  superficial  for  several  inches  below  this.  Pres- 
sure may  further  be  made  by  means  of  a  padded 
stick,  a  Spanish  windlass,  a  tourniquet,  the  elastic 
bandage,  or  by  the  knotted  handkerchief  com- 
bined with  flexion  of  the  thigh  on  the  belly,  and 
of  the  leg  on  the  thigh. 

For  Hemorrhage  from  the  Arteries  of  the 
Leg,  pressure  should  be  applied  over  the  course  of 
the  large  blood-vessel,  which  is  superficial  in  the 
hollow  behind  the  knee-joint.  This  pressure  may 
be  made  by  means  of  the  elastic  bandage,  or  by 
the  knotted  handkerchief  combined  with  flexion 
of  the  leg  on  the  thigh  and  of  the  thigh  on  the 
abdomen. 

For  Hemorrhage  from  Arteries  of  the  Foot, 
the  bandage  and  pad  maybe  applied,  or  the  above 
measure  may  be  employed. 

Internal  Hemorrhage,  by  which  is  understood 
any  bleeding  in  the  great  cavities  of  the  trunk  in 
which  the  blood  accumulates  internally,  may  be 
suspected  when,  after  injury,  liable  to  ^ use  it, 
symptoms  of  faintness  from  loss  of  blood  come  on 
(vide  Fainting).  //  is  to  be  treated  by  rest  in  the 


INTERNAL   HEMORRHAGE  AND   FAINTING,     33 

recumbent  position,  the  head  lying  lowest \  and  cold 
applications  externally. 

Fainting  is  one  of  the  results  of  copious  hemor- 
rhage. If  it  occurs  as  the  result  of  excessive 
hemorrhage,  the  bleeding  should  first  of  all  be 
controlled.  The  patient  should  be  laid  on  his 
back,  with  his  head  low ;  his  arms  and  feet  may 
be  elevated.  Tight  clothing  should  be  loosened 
and  cold  water  sprinkled  upon  the  face.  The 
application  of  warmth  to  the  body,  the  holding  of 
hartshorn  to  the  nostrils,  and  the  careful  adminis- 
tration of  stimulants  (when  the  patient  is  able  to 
swallow)  may  be  necessary. 

It  must  be  borne  in  mind  that  with  the  advent 
of  a  fainting  spell  and  its  attendant  weakening  of 
the  heart's  action  a  cessation  of  hemorrhage  often 
takes  place  naturally  ;  hence  measures  are  to  be 
adopted  to  prevent  a  recurrence  of  the  bleeding 
when  reaction  comes  on. 

In  fainting  from  internal  hemorrhage  the  treat- 
ment outlined  above  will  in  the  main  be  applicable, 
stimulants,  if  given  at  all,  being  administered  with 
extreme  caution. 

It  may  here  be  mentioned  that  fainting  is  due  to 
numerous  causes  besides  hemorrhage.  Debility  in 
general,  fright,  and  nervous  impression  of  various 
kinds  may  produce  it. 

FIRST  AID  TREATMENT  OF  WOUNDS. 

A  Wound  is  any  breach  in  the  soft  tissues  of  the 
body  caused  by  violence.  Upon  the  battle-field 


34      THE   SOLDIER'S   FIRST  AID   HANDBOOK. 

the  following  forms  of  this  class  of  injury  will 
present  themselves,  viz.,  the  contused,  the  incised, 
the  punctured,  the  lacerated,  and  the  gunshot 
wound.  Contusions,  though  not  properly  wounds, 
may  advantageously  be  considered  with  them. 

Contusions,  or  bruises,  are  caused  by  blunt, 
heavy  instruments.  On  the  battle-field  they  re- 
sult from  falls,  blows  with  the  butt  of  a  gun,  the 
passage  of  a  wagon  or  piece  over  a  portion  of  the 
body,  etc.  Ordinarily,  they  are  not  of  serious 
nature  ;  but  complicated  with  injuries  of  internal 
organs  or  fractures,  their  import  is  much  graver. 
Simple  contusions  are  treated  with  applications 
of  cold  water  or  of  laudanum.  Hot,  wet  applica- 
tions are  of  use  where  "the  pain  has  ceased;  they 
favor  the  absorption  of  the  blood  which  has 
escaped  into  the  tissues.  If  the  bruise  is  com- 
plicated by  fracture,  the  latter  should  be  attended 
to  in  a  manner  to  be  described  hereafter.  If  the 
patient  is  unconscious  from  a  blow  on  the  head, 
the  bearers  should  not  try  to  bring  him  to  his 
senses  by  shaking  him,  but  should  sprinkle  cold 
water  upon  his  face  and  chest  for  that  purpose, 
and  place  him  under  care  of  the  surgeon  without 
delay. 

A  Contused  Wound  is  a  bruised  one,  and  as 
far  as  its  management  in  general  is  concerned,  it 
may  be  considered  as  a  species  of  contusion. 
Ordinarily,  a  moist,  cold  dressing  of  lint  with  a 
compress  and  bandage  suffices.  Should  hemor- 
rhage exist,  not  controllable  by  the  pressure  of 
the  dressing,  the  elastic  bandage,  windlass,  tour- 


FIRST  AID  TREATMENT  OF  WOUNDS.         35 

niquet,  etc.,  should  be  employed.  The  complica- 
tions of  the  contused  wound  are  those  of  the  con- 
tusion. 

When  the  word  lint  is  employed  herein  in  con- 
nection with  the  dressing  of  wounds,  either  the 
picked,  shredded,  or  sheeted  article,  or  its  cotton 
substitutes,  are  to  be  understood.  Preferably, 
all  dressings  should  be  antiseptic.  The  antiseptic 
compress  of  the  Esmarch's  package  serves  the 
purpose  both  of  lint  and  ordinary  compress. 

An  Incised  Wound  is  a  cut  such,  for  instance, 
as  is  made  by  the  sabre.  Hemorrhage  may  be 
slight,  in  which  case  a  dressing  of  lint  and  a  com- 
press, covered  by  a  roller  or  triangular  bandage, 
snugly  applied,  will  check  it.  Should  it  be  severe, 
recourse,  in  addition,  must  be  had  to  the  elastic 
bandage  or  other  appliance  of  its  class ;  or  pres- 
sure with  the  fingers,  as  in  wounds  of  the  carotid 
artery,  may  have  to  be  employed.  Patients  with 
vertical  cuts  of  the  walls  of  the  belly  should  be 
carried  lying  on  their  backs,  those  with  horizon- 
tal cuts  are  to  be  transported  seated.  Incised 
wounds  of  the  belly  are  occasionally  followed 
by  protrusion  of  the  bowels.  If  not  injured  or 
soiled,  gentle  efforts  should  be  made  to  return 
the  intestines.  If  this  is  unsuccessful,  they  should 
be  covered  and  protected  by  a  clean  cloth  while 
the  patient  is  conveyed  to  the  dressing  station. 

A  Punctured  Wound  is  made  by  a  stabbing 
weapon,  such  as  a  bayonet.  Generally  there  is 
but  little  hemorrhage,  and  the  ordinary  dressing 
is  sufficient  for  the  purposes  of  exerting  pressure. 


36    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

Fragments  of  the  weapon  left  in  the  wound  should 
not  be  removed  by  the  bearer,  but  by  the  sur- 
geon. If  the  lungs  have  been  injured,  which  in 
some  cases  may  be  suspected  from  the  location  of 
the  wound,  and  the  coughing  up  of  blood,  etc., 
the  patient  is  neither  to  be  conveyed  in  a  wagon 
nor  allowed  to  walk  to  the  dressing  station,  but 
must  be  carried  thither  on  a  stretcher. 

A  Lacerated  Wound  is  one  in  which  the  parts 
have  been  torn.  The  ragged  stump  left  when  a 
portion  of  the  hand  has  been  wrenched  off  by  a 
premature  explosion  is  an  example.  The  wound 
should  be  cleansed  and  foreign  bodies  removed 
by  a  gentle  stream  of  water  from  a  sponge ;  the 
parts  should  be  restored  to  their  natural  positions 
as  far  as  possible,  and  a  cool,  wet  cloth,  or  one 
moistened  with  laudanum  or  alcohol,  is  then  to  be 
applied  and  covered  with  the  bandage.  If  hem- 
orrhage is  severe,  the  tourniquet  or  other  means 
for  arresting  it  may  have  to  be  employed.  If  the 
injury  is  great  and  the  patient  is  suffering  from 
shock,  stimulants  may  be  called  for.  Extensive 
lacerations  should  ribt  be  treated  with  cold  appli- 
cations ;  where  hot  ones  are  not  available,  dry 
dressing  or  cloths  moistened  with  alcohol  or  laud- 
anum are  preferable. 

Gunshot  Wounds  are  produced  by  missiles 
projected  from  weapons  loaded  with  explosive 
material.  These  missiles  include  bullets,  gun- 
shot, shrapnel,  shells,  grape  and  canister  shot, 
etc.  Gunshot  wounds  involving  merely  the  skin 
and  muscles  are  trivial,  but  such  as  are  compli- 


FIRST    AID   TREATn.         37 


cated  with  injury  to  the  intertill  organs  or  with 
fractures,  are  among  the  gravest  of  the  casualties 
of  war.  The  amount  of  bleeding  attending  these 
cases  is  variable.  The  management  of  gunshot 
wounds  depends  upon  whether  they  are  simple 
flesh  wounds,  or  are  complicated  with  hemorrhage 
01  fracture.  Flesh  wounds,  after  thorough  cleans- 
ing, are  dressed  with  lint,  compress,  and  bandage. 
Hemorrhage,  if  serious,  requires  the  tourniquet, 
or  othei  means  of  this  class,  to  control  it,  while 
fractures  are  to  be  treated  in  a  manner  to  be 
described  hereafter.  Frequently,  when  a  portion 
of  a  limb  has  been  torn  off  by  a  fragment  of  a 
shell,  there  is  little  or  no  bleeding  from  the 
arteries,  because  the  wrenching  force  has  twisted 
the  arterial  coats  in  such  a  manner  as  to  close  the 
vessels.  They  are  not  so  firmly  closed,  however, 
but  what  a  jar  may  start  the  hemorrhage  ;  hence, 
as  a  safeguard,  the  tourniquet  is  loosely  adjusted 
over  the  course  of  the  main  artery  of  the  limb. 
Gunshot  wounds  generally  have  an  opening  of 
entry  and  one  of  exit  ;  in  case  the  projectile  fails 
to  emerge,  the  latter,  of  course,  is  absent.  Bearers 
should  not  try  to  remove  imbedded  projectiles. 

Theyfrj/  aid  package  of  Esmarch  will  be  found 
to  be  available  as  a  first  dressing  for  all  classes  of 
wounds. 

Shock  is  a  form  of  collapse  accompanying 
severe  injuries.  Fright,  despondency,  hunger, 
thirst,  and  debility  favor  its  development,  while 
loss  of  blood  aggravates  it.  The  symptoms  are 
those  of  utter  prostration.  The  skin  is  pale,  cold, 


38    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

and  clammy;  the  breathing  shallow,  the  pulse 
feeble;  the  eyes  are  dull,  the  eyelids  drooping, 
and  the  pupils  dilated.  The  patient's  mind  wan- 
ders, and  unconsciousness  sometimes  comes  on. 
Well-marked  shock  is  a  serious  condition,  and 
demands  prompt  measures.  The  patient  is  to  be 
laid  down,  head  low,  and  covered  with  blankets, 
all  hemorrhage  having  been  checked.  Hot  appli- 
cations (hot  bottles,  hot  plates,  etc.)  should  be 
made  to  the  whole  body,  and  especially  to  the 
region  of  the  heart  and  the  pit  of  the  stomach, 
care  being  taken  that  the  heated  articles  are  not 
laid  directly  upon  the  bare  skin.  Hot  drinks 
should  be  given,  or  a  teaspoonful  of  brandy  in  a 
tablespoonful  of  water  administered  every  ten 
minutes  for  several  hours.  When,  however,  there 
is  suspicion  of  internal  hemorrhage,  liquor  had  bet- 
ter be  omitted,  unless  given  with  extreme  caution. 

FIRST    AID    TREATMENT    OF    FRAC- 
TURES. 

Fracture. — When  a  bone  is  broken  a  fracture 
is  said  to  have  taken  place.  Fractures  may  be 
classed  as  simple  and  compound:  in  the  former 
the  skin  is  not  broken,  in  the  latter  it  is.  A  com- 
pound fracture  is  a  very  much  graver  injury  than 
a  simple  one.  That  a  bone  has  been  broken  can 
be  recognized  by  the  occurrence  of  pain,  by  the 
faulty  position  of  the  limb,  by  its  bending  where 
it  ought  not  to,  and  by  the  so-called  crepitus,  or 
grating  sound  or  sensation,  produced  by  motion 


FIRST  AID  TREATMENT   OF  FRACTURES.      39 

at  the  seat  of  injury.  Pain  is  usually  not  marked 
when  the  limb  is  quiescent,  but  the  patient's  efforts 
to  move  it,  or  unskilful  handling  thereof,  cause 
acute  suffering.  It  is  the  duty  of  the  bearers  to 
support  the  affected  limbs  by  means  of  splints, 
and  to  keep  the  fracture  immovable.  A  rectifica- 
tion of  the  faulty  position  of  the  fragments  of  the 
bones  is  not  to  be  attempted  by  them,  unless 
excessive  pain  calls  for  such  a  measure.  To  effect 
it,  one  man  grasps  the  limb  above  the  fracture 
and  the  other  below,  both  pulling  in  opposite 
directions  until  the  proper  shape  is  restored.  Care 
must  be  exercised  not  to  increase  the  damage 
already  done. 

Extemporary  Splints,  made  from  a  variety  of 
material  available  on  the  battle-field,  are  utilized 
by  the  bearer  in  putting-up  fractured  limbs  for  the 
time  being.  The  articles  from  which  they  are 
improvised  comprise  rifles,  side-arms,  coats,  capes, 
knapsacks,  straw-mats,  rolls  of  straw,  boards, 
pickets,  sticks,  bark,  laths,  switches,  rushes, 
leather  straps,  telegraph  wire,  strips  of  tin,  and 
many  others.  Temporary  splints  may  be  applied 
directly  to  the  limb  or  over  the  clothing,  accord- 
ing to  circumstances.  Their  mode  of  application 
will  be  shown  in  the  consideration  of  the  follow- 
ing fractures: 

Fractures  of  the  Upper  Arm  may  be  put  up 
with  a  bayonet  and  scabbard,  one  on  each  side, 
or  with  bundles  of  straw  lined  with  soft  material. 
Again,  thin  pieces  of  board  may  be  applied  to 
the  inside  and  outside  of  the  limb,  and,  if  neces- 


40    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

sary,  to  the  front  and  rear  also.  In  all  cases  the 
splints  are  firmly  held  together  with  triangular  or 
other  bandages,  and  the  fore-arm  is  flexed  and 
carried  in  a  sling.  The  simplest  method  is  to 
utilize  the  chest  as  a  splint.  The  elbow  is  drawn 
down  to  the  side  of  the  body,  a  layer  of  cotton  or 
linen  cloth  being  interposed.  The  whole  "upper 
arm  is  then  to  be  bound  to  the  chest,  the  fore- 
arm being  carried  in  a  sling,  the  hand  a  little 
higher  than  the  elbow. 

Fracture  at  the  Lower  End  of  the  Arm. — 
This  may  be  put  up  with  a  rectangular  inside  splint 
in  order  that  more  support  be  afforded  than  can 
be  given  by  the  straight  splint.  The  rectangular 
splint  may  be  improvised  from  telegraph-wire,  and 
should  be  well  padded. 

The  outside  of  one  of  the  blades  of  the  ordi- 
nary straight  scissors  should  be  provided  with  a  file 
edge,  by  which  a  notch  may  be  cut  in  the  wire  to 
weaken  it  and  cause  it  to  break  readily. 

Fracture  of  the  Fore-arm  is  put  up  with  two 
light  splints ;  shingles  are  well  adapted  for  the 
purpose.  The  fore-arm  being  flexed  and  the 
thumb  turned  upwards,  the  splints,  well  padded 
and  long  enough  to  extend  beyond  the  fingers, 
are  applied  to  the  front  and  rear  of  the  limb,  and 
firmly  bound  on  ;  the  hand  is  carried  in  a  sling 
and  raised  slightly  higher  than  the  elbow. 

Whenever  a  sling  is  required  for  the  fore-arm, 
one  may  be  conveniently  made  by  turning  up  the 
bottom  of  the  blouse,  passing  it  over  the  limb, 


FIRST  AID  TREATMENT  OF  FRACTURES.     4! 

and  pinning  it  to  the  breast  of  the  garment.  If 
necessary,  the  side  seam  may  be  slit  up. 

Fracture  of  the  Finger  may  be  put  up  with  a 
light  splint  reaching  from  wrist  to  finger-tip,  the 
finger  being  straightened  out. 

Fracture  of  the  Thigh  may  be  put  up  with  a 
splint  placed  on  the  outer  side  of  the  limb  and 
extending  from  axilla  to  foot.  For  this  purpose 
a  rifle  may  be  used,  with  the  butt  placed  in  the 
armpit  and  the  hammer  pointing  towards  the 
ground.  The  weapon  is  secured  by  a  bandage 
passing  around  the  foot  and  another  passing 
around  the  trunk,  each  being  made  to  encircle  the 
splint.  A  soldier's  overcoat  is  then  adjusted  so 
as  to  constitute  a  pad  on  one  side  of  the  limb, 
and  passing  under  it,  to  form  a  stiff  roll  on  the 
other,  the  whole  being  fastened  by  straps,  band- 
ages, handkerchiefs,  etc. 

Fracture  of  the  Knee-Pan  may  be  put  up 
with  a  straight  splint  extending  from  hip  to 
heel  on  the  outer  side  of  the  limb.  A  picket  may 
be  used,  if  available. 

In  fractures  of  the  lower  extremity,  in  general, 
the  limb  should  not  be  held  absolutely  straight, 
but  slight  bending  at  the  knee  should  be  allowed. 

In  Fracture  of  the  Leg  the  limb  may  be  care- 
fully drawn  down  and  placed  in  a  natural  posi- 
tion. An  overcoat  or  cape  should  then  be  passed 
under  it  and  made  to  form  a  stiff  roll  on  each 
side.  A  piece  of  board,  a  pair  of  bayonets,  or  a 
sword,  etc.,  is  then  laid  along  the  limb  over  the 
coat  and  secured  by  bandages,  straps,  etc.,  or  the 


42     THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

other  leg  may  be  utilized  as  a  splint  to  which  the 
injured  one  is  bound. 

Fractures  of  the  Spine  is  difficult  to  detect. 
When  suspected,  the  patient  should  be  laid  upon 
his  back,  and  left  for  the  surgeon's  examination. 
He  is  not  to  be  disturbed  more  than  is  absolutely 
necessary. 

Fractures  of  the  Shoulder-Blade,  Hip-Bone, 
or  Ribs  are  frequently  hard  to  make  out ;  the 
first  two  are  rare.  First-aid  treatment  consists  in 
placing  the  sufferer  in  a  comfortable  position  and 
securing  rest  and  coolness. 

In  Fracture  of  the  Collar-Bone  the  patient 
should  be  laid  flat  on  his  back  without  pillow, 
the  arm  bound  to  the  side  and  the  fore-arm  se- 
cured in  a  sling  made  of  the  turned-up  bottom  of 
the  blouse  pinned  to  the  breast  of  the  garment. 

Fracture  of  the  Skull  calls  for  the  recumbent 
posture  and  cold  applications  to  the  head.  Fur- 
ther than  attending  to  these  requirements  and  to 
the  comfort  of  the  patient,  the  bearer  will  do 
nothing. 

In  Fracture  of  the  Jaw  the  mouth  is  to  be 
closed  and  a  bandage  applied  to  keep  the  teeth 
together. 

Compound  Fractures,  after  the  wound  has 
been  dressed,  are  to  be  put  up  in  like  manner  as 
the  simple  forms,  care  being  taken  that  the  frag- 
ments cause  no  further  damage  to  the  soft  tissues. 


IN  CASES  OF  SUSPENDED  ANIMATION.       43 

FIRST   AID   TREATMENT   OF   DISLO- 
CATIONS. 

Dislocations  consist  in  the  displacement  of  the 
articular  extremities  (joint  ends)  of  bones  from 
their  sockets.  The  bearer,  as  a  rule,  should  not 
attempt  their  reduction,  but  should  place  the  limb 
in  a  comfortable  position,  and  after  applying  cold 
dressings,  secure  it  by  bandages. 

In  the  service,  dislocations  are  often  caused  by 
men  being  thrown  from  horses,  caissons,  etc. 

FIRST  AID  TREATMENT  OF  SPRAINS. 

A  Sprain  is  caused  by  the  overstraining  of 
the  muscles  and  ligaments  covering  a  joint,  the 
force  exerted  stopping  short  of  that  required  to 
produce  a  dislocation.  The  wrist  and  ankle  are 
joints  most  frequently  affected  by  this  class  of 
injury.  Severe  sprains  sometimes  present  them- 
selves on  the  field  of  battle.  Their  treatment  re- 
sembles that  of  contusions ;  cold  dressings  and,  if 
necessary,  splints  are  applied  ;  later,  hot  applica- 
tions should  be  employed  to  produce  absorption. 

PROCEDURES  TO  BE  ADOPTED  IN 

CASES  OF  SUSPENDED 

ANIMATION. 

Often,  as  a  result  of  the  shock  of  severe  injuries, 
profuse  bleeding,  or  various  forms  of  obstruction 


44    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

to  breathing,  a  trance-like  condition  known  as 
suspended  animation  arises,  characterized  by  cessa- 
tion of  respiration,  and  an  all  but  complete  fail- 
ure of  the  heart's  action.  In  order  to  avert  death 
in  a  case  of  this  kind,  the  bearer,  in  addition  to 
the  measures  applicable  in  fainting  and  shock, 
will  employ  what  is  termed  artificial  respiration. 

By  Artificial  Respiration  is  meant  a  procedure 
in  which,  by  alternate  compression  and  expansion 
of  the  chest,  the  lungs  are  made  to  imitate  the 
natural  action  of  breathing.  There  are  several 
methods  of  artificial  respiration,  the  best  known 
among  which  are  Silvester's,  Marshall  Hall's,  and 
Howard's,  the  first  being  the  simplest,  and  readily 
carried  out  by  one  man.  It  will  be  more  advan- 
tageous for  the  bearer  to  confine  himself  to  one 
of  them,  learning  it  thoroughly,  than  to  endeavor 
to  master  them  all.  Silvester's  method  is  hence 
selected  for  the  purpose  of  description.  It  may 
be  occasionally  necessary  to  employ  artificial  res- 
piration for  hours ;  it  is  discontinued  when  nat- 
ural breathing  recommences,  or  the  case  is  finally 
given  up  as  hopeless. 

In  Silvester's  method  the  patient  is  laid  upon 
his  back,  with  the  arms  stretched  out  along  the 
side  of  the  body,  and  a  firm  roll  of  some  kind 
(clothing,  blanket,  etc.)  placed  under  the  shoulder- 
blades  for  the  purpose  of  raising  the  shoulders 
and  extending  the  throat.  The  tongue,  which 
has  a  natural  tendency  to  fall  back  and  obstruct 
the  wind-pipe,  is  drawn  forward  and  secured, 
either  by  a  string,  etc.,  passed  around  its  base  and 


IN  CASES  OF  SUSPENDED  ANIMATION.       45 

the  chin,  or  in  various  other  ways  that  may  sug- 
gest themselves.  Kneeling  behind  the  patient's 
head,  the  bearer  seizes  the  arms  above  the 
elbows,  and  draws  them  outwards  and  upwards 
until  they  are  fully  extended  above  the  head. 
After  a  pause  of  about  two  seconds  the  arms  are 
carried  back  to  their  original  positions,  the  bearer 
making  firm  pressure  upon  the  chest  at  the  same 
time.  This  procedure  is  carried  out  at  the  rate 
of  about  fifteen  times  a  minute.  Whenever  the 
arms  are  raised  the  chest  is  expanded  and  air 
enters  the  lungs  ;  when  they  are  brought  down 
and  pressure  is  made  upon  the  chest  the  latter 
is  compressed  and  air  is  expelled.  The  natural 
movements  of  respiration  are  hence  imitated. 


PART  III. 

MANAGEMENT  BY  THE  BEARER  OF  ORDINARY 
ACCIDENTS  AND  EMERGENCIES. 

IN  the  preceding  pages  the  scope  of  the  duties 
of  the  bearer  on  the  field  of  battle  have  been  out- 
lined ;  but  besides  ministering  to  the  needs  of 
those  wounded  in  combat  he  should  furthermore 
be  able  to  afford  first  aid  in  the  accidents  and 
emergencies  of  ordinary  garrison  life,  and  to  take 
care  of  minor  cases  when  the  surgeon's  services 
are  not  available. 


46    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 


GENERAL  RULES  TO   BE   OBSERVED 
IN  CASES  OF  ACCIDENT. 

Should  the  bearer  happen  to  be  present  at  the 
scene  of  an  accident  at  which  his  services  are 
called  upon,  he  should  first  of  all  request  by- 
standers, who  may  have  crowded  around,  to  press 
back  in  order  that  breathing-space  and  room  for 
manipulation  be  obtained.  If  he  needs  assistance, 
he  will  ask  for  as  few  helpers  as  he  can  get  along 
with.  The  patient  is  placed  in  a  comfortable 
position  upon  his  back,  tight  clothing  loosened, 
and  the  nature  and  extent  of  his  injuries  are  de- 
termined. The  examination  completed,  word  is 
s.ent  to  the  surgeon  and  the  hospital  steward,  the 
character  of  the  injury  being  stated  for  their  guid- 
ance in  the  matter  of  instruments  and  appliances 
necessary.  In  the  mean  time  the  bearer  will  adopt 
such  first-aid  measures  as  the  situation  may  call 
for,  being  careful  to  observe  the  limitations  of  his 
functions. 


HEMORRHAGE,  WOUNDS,   FRAC- 
TURES,  DISLOCATIONS, 
SPRAINS. 

These  accidents  having  already  received  con- 
sideration in  Part  II.,  need  not  be  discussed  here. 


ORDINARY  ACCIDENTS  AND  EMERGENCIES.    47 


CONDITIONS  CAUSING  LOSS  OF  CON- 
SCIOUSNESS. 

Loss  of  Consciousness  occurs  under  a  variety 
of  circumstances,  the  conditions  causing  it  being 
at  times  readily  discernible,  at  others  difficult  to 
discover.  It  may  be  due  to  fainting,  shock,  con- 
cussion, compression,  apoplexy,  or  other  disorder 
of  the  brain,  sunstroke,  heat-exhaustion,  intoxica- 
tion, epilepsy,  poison,  or  a  number  of  other  trou- 
bles. It  is  not  to  be  presumed  that  the  bearer  will 
be  able  to  make  what  the  surgeon  calls  a  differen- 
tial diagnosis  between  the  various  conditions  pro- 
ducing unconsciousness,  that  is  to  say,  to  ascertain 
absolutely  whether  insensibility  results  from  this, 
that,  or  the  other  cause.  Professional  study  is 
necessary  for  such  purpose ;  it  is  not  within  the 
scope  of  the  bearer's  duties.  He  will  mainly  have 
to  rely  on  what  he  may  learn  from  the  patient's 
associates,  and  on  circumstances  which  the  intelli- 
gent layman  may  reasonably  be  expected  to  ob- 
serve. When  the  bearer  is  in  doubt  as  to  the 
origin  of  unconsciousness,  as  he  may  well  be  in 
many  cases,  he  must  rely  upon  general  principles. 
In  all  instances  he  must  try  to  speedily  obtain  the 
surgeon's  services.  Pending  the  latter's  arrival, 
he  should  lay  the  patient  upon  his  back,  with  his 
head  slightly  elevated,  and  loosen  tight  clothing. 
If  there  be  pallor,  clamminess  of  surface,  shallow 
breathing,  and  weakness  of  pulse,  heat  should  be 
applied  to  the  body,  hartshorn  held  to  the  nose, 


48    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

and  hot  drinks  given  as  soon  as  the  patient  is  able 
to  swallow.  If  the  skin  feels  excessively  hot,  cold 
applications  should  be  made  to  the  head  and  body, 
and  cold  drinks  given  when  consciousness  returns. 

Fainting  and  Shock  have  already  received  at- 
tention in  a  preceding  chapter. 

Concussion  of  the  Brain  or  stunning  is  caused 
mainly  by  blows  or  falls  upon  the  head.  It  is 
accompanied  by  feeble  pulse  and  vomiting,  pallor, 
depression,  incoherence  of  language,  and  partial 
or  complete  insensibility.  The  proper  plan  of 
treatment  is  to  lay  the  patient  upon  his  back, 
loosen  tight  clothing,  and  secure  quiet  and  fresh 
air.  Heat  should  be  applied  if  the  skin  becomes 
cold  and  clammy.  Stimulants  had  better  be 
avoided. 

Compression  of  the  Brain  is  due  either  to 
pressure  exerted  upon  the  organ  by  a  fragment 
of  a  broken  skull-bone,  or  by  blood  which  has  es- 
caped into  the  cranial  cavity  from  a  vessel  rup- 
tured as  a  result  of  external  violence.  The  symp- 
toms are  insensibility,  slow  pulse,  snoring,  breath- 
ing, paralysis,  muscular  twitching  or  convulsions, 
and  dilatation  of  one  or  both  pupils.  The  recum- 
bent position  should  be  secured  for  the  patient, 
and  cold  applications  made  to  his  head ;  beyond 
this  the  bearer  will  attempt  nothing  without  med- 
ical advice. 

Apoplexy  is  due  to  the  rupture  of  a  diseased 
blood-vessel  in  the  brain  without  external  violence. 
Usually  the  patient's  face  is  flushed,  and  may  be 
drawn  to  one  side.  The  loss  of  consciousness 


ORDINARY  ACCIDENTS   AND   EMERGENCIES.    49 

may  be  gradual,  or  insensibility  may  come  on  sud- 
denly. The  pulse  is  slow,  the  breathing  snoring. 
The  bearer  will  adopt  the  same  measures  as  in 
compression  of  the  brain. 

Sunstroke  is  due  to  overheating  of  the  body, 
Associated  with  an  inability  of  the  skin  to  perform 
Its  proper  functions  on  account  of  the  influences 
of  a  close  atmosphere.  Its  symptoms  of  warn- 
ing are  headache  and  oppression.  These  after  a 
time  are  followed  by  loss  of  consciousness.  The 
breathing  is  labored,  the  skin  intensely  hot,  perspi- 
ration absent ;  the  bladder  and  bowels  sometimes 
discharge  involuntarily.  The  great  aim  in  treat- 
ing this  most  serious  condition  is  to  reduce  the 
bodily  temperature  as  soon  as  possible.  The  patient 
should  be  immediately  conveyed  to  a  cool,  airy 
place,  and  on  removal  of  his  clothing  placed  in  a 
cold  bath,  or  wrapped  in  a  wet-pack,  that  is  to  say, 
in  sheets  soaked  in  water,  and  which  in  this  case 
are  kept  wet  by  repeated  applications  of  cold  or 
iced  water.  If  these  methods  are  impracticable, 
cold  must  be  employed  in  some  other  way,  as  by 
thorough  and  continued  sponging  of  the  body 
and  head,  lumps  of  ice  being  rubbed  over  the 
chest  and  placed  over  the  large  blood-vessels  in 
the  armpits  and  groins.  If  consciousness  returns, 
the  application  of  cold  should  be  discontinued, 
to  be  renewed  only  if  the  temperature  again  rises 
above  normal,  or  insensibility  comes  on  once  more. 

Heat  Exhaustion  is  a  prostration  of  the  sys- 
tem due  to  excessive  heat,  but  is  not  accompanied 
by  loss  of  the  transpiratory  function  of  the  skin. 


50    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

It  resembles  the  ordinary  fainting  spell,  and  is  to 
be  similarly  treated,  the  patient  being  removed  to 
a  cool,  airy  spot.  Unlike  sunstroke,  this  condition 
presents  a  moist,  cool  skin. 

Intoxication  in  its  fully  developed  symptoms 
somewhat  resembles  apoplexy.  When  the  bearer 
is  certain  that  the  case  is  one  of  drunkenness, 
an  emetic  composed  of  a  teaspoonful  of  ground 
mustard  stirred  up  in  a  teacupful  of  lukewarm 
water  may  be  given.  This  is  to  be  followed  by  a 
teaspoonful  of  aromatic  spirits  of  ammonia  in  a 
similar  quantity  of  water,  or  a  large  draught  of 
vinegar,  after  vomiting  has  occurred.  If  the 
patient  be,  as  is  called,  dead-drunk,  and  in  danger 
of  dying  from  the  collapsing  effects  of  the  liquor, 
the  general  application  of  heat  to  the  body  is 
imperative.  Emetics  should  not  be  employed  if 
the  bearer  is  not  absolutely  certain  of  the  nature 
of  the  case,  as  in  apoplexy  they  would  create  ir- 
reparable damage.  In  cases  of  doubt  the  precau- 
tions necessary  in  apoplexy  should  be  adopted. 

Epileptic  Seizures,  in  the  main,  should  be 
treated  like  fainting  spells.  No  attempt  should 
be  made  to  violently  prevent  the  spasmodic  move- 
ments :  they  should  simply  be  controlled.  To 
forestall  biting  of  the  tongue,  a  folded  towel  or 
some  other  available  article  should  be  thrust  be. 
tween  the  teeth, — not  in  such  a  manner,  however, 
as  to  interfere  with  breathing.  After  the  seizure 
is  over,  rest  in  the  recumbent  posture  is  necessary. 

Poisons,  such  as  opium  and  chloral,  produce 
insensibility  when  taken  in  overdose.  If  the 


ORDINARY  ACCIDENTS  AND   EMERGENCIES.    $1 

bearer  knows  that  these  drugs  have  been  used,  he 
will  adopt  the  first-aid  measure  to  be  hereafter 
detailed  as  applicable  in  cases  of  poisoning ;  often, 
however,  the  cause  of  the  patient's  unconscious- 
ness will  be  unknown  to  him.  In  all  cases,  how- 
ever, he  will  lose  no  time  in  communicating  with 
the  surgeon. 

ASPHYXIA. 

Asphyxia  is  a  term  applied  to  all  accidental 
conditions  in  which  life  is  in  danger  on  account  of 
any  obstruction  whatsoever  to  respiration.  The 
conditions  mentioned  include  suffocation  from 
drowning,  strangulation,  noxious  gases,  foreign 
bodies  in  windpipe  or  gullet,  etc. 

In  Drowning,  if  the  patient  hass  topped  breath- 
ing, tight  clothing  is  first  of  all  loosened,  the  in- 
dividual is  then  turned  over  on  his  face,  a  roll  of 
clothing,  a  rolled  blanket,  etc.,  being  placed  under 
his  stomach,  his  mouth  and  nose  are  cleared  of 
sand,  mud,  or  other  substances  collected  therein, 
and  pressure  is  made  upon  the  spine  and  kept  up 
until  water  ceases  to  flow  from  the  mouth.  The 
patient  is  then  turned  over  on  his  back,  and  the 
roll  placed  under  his  shoulder-blades  so  as  to  raise 
the  shoulders  and  extend  the  throat.  The  tongue 
being  drawn  well  forward,  is  either  secured  by  a 
string  or  rubber  band  passing  around  the  base  of 
the  organ  and  the  chin,  fixed  by  thrusting  a  small 
stick  or  pencil  across  the  top  of  it  behind  the 
molar  teeth,  or  }i^ld  by  an  assistant,  These  pro- 


52    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

cedures  accomplished,  Silvester's  method  of  arti- 
ficial respiration  should  be  practised  in  the  manner 
indicated  on  page  44.  It  should  be  kept  up  for 
hours  if  necessary,  and  until  natural  breathing  re- 
turns, or  the  case  has  been  given  up  as  hopeless 
by  competent  authority. 

While  the  bearer  has  been  busied  with  the 
drowned  man,  bystanders  have,  by  his  direction, 
been  sent  to  obtain  warm  and  dry  coverings  to 
replace  the  wet  clothes  of  the  patient.  A  fire 
should  be  built  by  others,  by  which  water,  bricks, 
stones  or  pieces  of  metal  may  be  heated,  and 
blankets,  coverings,  clothes,  thoroughly  warmed. 
An  assistant,  without  interfering  with  the  process 
of  artificial  respiration,  pulls  off  the  wet  clothes, 
replaces  them  by  warm  coverings,  applies  heat  to 
the  body  in  the  shape  of  hot  bottles,  hot  bricks, 
or  hot  stones,  properly  covered,  or  even  the  hot 
sand  of  the  beach.  The  body  and  limbs  should 
be  constantly  rubbed  towards  the  heart. 

As  soon  as  the  patient  is  able  to  swallow,  a  tea- 
spoonful  of  hot  liquor  in  a  tablespoonful  of  water 
may  be  given  every  few  minutes  until  the  danger 
is  over. 

As  soon  as  the  patient  begins  to  breathe  of  his 
own  accord,  the  artificial  process  should  be  timed 
to  aid  the  natural  respiration.  Breathing  may  be 
stimulated  by  holding  hartshorn  to  the  nose, 
slapping  the  skin,  or  by  dashing  hot  water  upon 
the  chest. 

As  a  rule,  the  drowned  man  should  never  be 
removed  during  the  employment  of  methods  for 


ORDINARY  ACCIDENTS  AND   EMERGENCIES.    $3 

his  resuscitation.  After  he  has  been,  so  to  speak, 
brought  back  to  life,  he  should  be  cautiously  car- 
ried away  in  the  recumbent  position,  put  in  a 
warm  bed,  and  carefully  watched  for  stoppage  of 
breathing. 

If  the  patient  has  not  stopped  breathing  when 
drawn  out  of  the  water,  the  procedure  is  similar 
to  that  employed  in  the  preceding  case,  artificial 
respiration,  however,  being  omitted  except  when 
the  natural  function  begins  to  fail. 

Strangulation  from  Hanging,  etc.,  is  treated 
by  removal  of  the  obstruction,  stimulating  natural 
breathing,  and,  if  necessary,  by  performing  arti- 
ficial respiration. 

In  Suffocation  with  Gases  the  patient  is  first  of 
all  to  be  carried  into  a  pure  atmosphere.  Breath- 
ing is  to  be  stimulated  by  sprinkling  the  face  with 
cold  water,  tickling  the  throat  and  nostrils  with  a 
feather,  the  application  to  the  nose  of  ammonia, 
etc.  If  necessary,  artificial  respiration  may  be 
employed. 

Caution  is  necessary  in  the  rescue  of  these  pa- 
tients from  their  dangerous  surroundings,  and  the 
bearer  should  take  adequate  measures  to  protect 
himself.  In  entering  a  room  filled  with  illumin- 
ating gas  he  should  be  careful  to  carry  no  light. 
When  the  patient  is  to  be  hauled  up  from  a  well  or 
vault,  the  gas  in  it  may,  in  a  measure,  be  dissi- 
pated by  throwing  down  a  few  buckets  of  water. 
A  cloth,  veil,  or  like  covering  worn  over  the  head 
will  prove  of  some  value  to  the  rescuer  in  keep- 
ing the  gas  out  of  his  lungs, 


54    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

Suffocation  from  Foreign  Bodies  in  the 
Windpipe  or  Gullet  is  to  be  treated  by  a  prompt 
removal  of  the  obstruction,  and,  if  necessary,  the 
subsequent  employment  of  artificial  respiration. 
Substances  clogging  the  windpipe  cause  a  good 
deal  of  coughing  :  those  obstructing  the  gullet  in- 
terfere with  swallowing,  but  do  not  give  rise  to 
cough.  If  the  foreign  body  can  be  reached,  it 
should  be  pulled  out  by  the  fingers,  a  bent  hair- 
pin, a  pair  of  blunt-pointed  scissors,  etc.  Some- 
times blowing  forcibly  into  the  ear  causes  a  reflex 
cough,  which  is  sufficient  to  dislodge  the  body. 
Foreign  bodies  in  the  windpipe  are  generally 
coughed  up  ;  if  not,  the  case  will  require  the  sur- 
geon's services.  Coughing  may  be  aided  by  blows 
on  the  back,  and  a  quick  compression  of  the  chest 
by  the  hands.  Inversion  (turning  upside  down) 
of  the  body  may  dislodge  the  substance.  When 
breathing  is  not  interfered  with  and  the  foreign 
body  is  not  accessible,  the  bearer  will  limit  him- 
self to  causing  the  patient  to  lie  down,  and  mak 
ing  him  as  comfortable  as  possible  pending  the 
surgeon's  arrival. 

In  connection  with  the  above,  and  as  coming 
within  the  scope  of  the  bearer's  duties  to  carry 
out  a  line  of  simple  treatment  in  absence  of  the 
surgeon,  it  may  here  be  mentioned  that  after  a 
foreign  body  has  been  swallowed,  and  particularly 
if  it  be  one  with  sharp  points,  a  generous  solid 
diet,  including  a  liberal  allowance  of  vegetables, 
should  be  given,  in  order  that  the  substance  may 


ORDINARY   ACCIDENTS  AND   EMERGENCIES.    55 

thus  be  imbedded  in  the  solid  waste  of  the  intesti- 
nal canal.     No  purgative  should  be  administered. 

BURNS  AND  SCALDS. 

In  Burns  and  Scalds  the  first  thing  to  do  is 
of  course  to  remove  the  cause.  Should  clothing 
have  caught  fire,  the  individual  is  to  be  thrown 
down  on  the  ground  and  deluged  with  water  or 
rolled  in  an  available  rug,  blanket,  or  coat.  Great 
damage  arises  from  the  inhalation  of  flames,  hence 
in  wrapping  up  a  patient,  the  bearer  should  first 
cover  the  upper  part  of  the  body.  When  cloth- 
ing is  removed  before  dressing  the  injury,  adher- 
ent portions  should  be  carefully  cut  out  of  the 
garment  and  left.  The  dressings  required  and 
the  further  treatment  necessary  are  given  in  the 
following  paragraphs. 

Slight  Burns  or  Scalds  are  best  treated  with 
cold  applications.  Involving  an  extremity,  the 
limb  may  be  entirely  immersed  in  water.  A  so- 
lution of  bicarbonate  of  soda  (baking-soda),  com- 
posed of  a  heaped  tablespoonful  of  this  substance 
to  a  teacupful  of  water,  soon  relieves  pain ;  the 
soda  may  also  be  used  in  bulk,  slightly  moistened. 
White  of  egg,  carron-oil  (lime-water  and  linseed- 
oil  mixed  in  equal  parts),  and  lather  applied  with 
a  shaving-brush  are  also  useful. 

In  Burns  and  Scalds  causing  Blisters  the 
latter  are  to  be  carefully  opened  with  needle  or 
scissors.  •  Applications  of  cold  water,  fresh  leaves, 
thinly  sliced  or  grated  potatoes,  white  of  egg,  or 


56    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

carron-oil  will  be  found  of  value,  the  great  object 
of  these  dressings  being  to  exclude  air.  Sub- 
stances which  crust  or  cake  should  be  avoided. 

Deep  Burns  or  Scalds  may  first  be  treated 
with  a  water  dressing,  preferably.  The  surgeon 
should  be  called  upon  for  a  further  management 
of  the  case. 

Shock  occurring  as  a  Result  of  an  extensive 
Burn  or  Scald  should  be  treated  in  a  similar 
manner  to  shock  in  general. 

FREEZING. 

In  cases  of  Freezing,  a  warning  symptom  of 
danger  is  an  uncontrollable  desire  to  lie  down  and 
sleep,  which  the.  sufferer's  companions  should  do 
their  best  to  prevent.  On  reaching  a  place  of 
shelter  and  treatment,  the  sufferer  must  be  gently 
handled,  as  otherwise  parts  of  the  body  such  as 
fingers,  toes,  the  ears,  are  liable  to  be  broken  off. 
He  must  never  be  brought  immediately  into  a 
warm  apartment,  but  efforts  at  bringing  him  to 
must  be  made  in  a  cold  room.  The  clothes  must 
be  cut  off,  if  necessary.  The  patient  must  be 
rubbed  all  over  with  cold  water,  snow,  or  put  in 
cold  wet  sheets,  until  he  becomes  limber  enough 
to  justify  removal  to  a  cold  bed.  Artificial  respi- 
ration is  now  to  be  employed,  if  called  for,  and 
warm  drinks  (not  stimulants)  are  given  as  soon  as 
he  is  able  to  swallow. 

Frost-Bites,  that  is  to  say,  local  freezing  of 
exposed  portions  of  the  body,  are  to  be  similarly 


ORDINARY  ACCIDENTS  AND   EMERGENCIES.    5/ 

treated  as  to  friction  with  cold  water  and  snow. 
The  same  cautions  obtain  as  to  sudden  exposure 
to  warmth.  Very  often  a  person  afflicted  with 
frost-bite  is  unaware  of  his  trouble,  as  the  affected 
part  has  utterly  lost  all  feeling.  A  passer-by  will 
recognize  the  dangerous  condition  of  the  organ, 
supposing  it  is  the  ear  or  nose,  by  the  blanched, 
waxy  appearance  it  presents.  Prompt  measures 
should  be  taken  immediately  to  prevent  total  loss 
of  the  member. 

Chilblains  are  due  to  a  chilling  of  the  circula- 
tion of  certain  parts,  particularly  the  toes.  They 
are  attended  with  a  good  deal  of  discomfort  in 
the  way  of  itching  and  smarting,  especially  mani- 
fested after  the  patient  has  gone  to  bed.  A  good 
plan  to  avert  these  symptoms  is  to  generally  keep 
the  affected  parts  away  from  the  fire,  and  to  bath 
them  in  cold  water  or  rub  them  with  snow  before 
retiring.  Stimulating  ointment  may  then  be  ap- 
plied, as,  for  instance,  the  compound  ointment  of 
resin. 

SORENESS  OF  THE    FEET. 

Soreness  of  the  Feet,  in  those  unaccustomed 
to  marching,  may  be  avoided  by  soaping  or  greas- 
ing the  feet  thoroughly  before  setting  out.  The 
march  made,  they  should  be  washed  or  wiped 
clean  and  dry.  The  feet  may  be  rendered  tough 
by  soaking  them  in  strong  tepid  solutions  of  alum 
or  tannin. 

The    German  Fussstreupulver 


58    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

preventive  of  sore  feet.  Sifted  in  shoes  and  stock- 
ings, it  keeps  the  feet  dry,  prevents  chafing,  and 
heals  sore  spots.  It  is  composed  mainly  of  soap- 
stone,  to  which  starch  and  salicylic  acid  have  been 
added  (87  parts  soapstone,  10  starch,  3  salicylic 
acid,  by  weight). 

Blisters  should  be  punctured  at  the  lowest 
point,  and  the  fluid  allowed  to  drain. 

BLEEDING  FROM  THE  NOSE,  LUNGS, 
STOMACH,  OR  BOWELS. 

Nose-Bleed  is  often  salutary,  being  a  natural 
method  of  relief  in  rush  of  blood  to  the  head. 
Occasions  may  arise,  however,  when  it  is  so  co- 
pious as  to  create  alarm  and  necessitate  the  sur- 
geon's services.  In  this  emergency  the  bearer 
should,  pending  the  latter's  arrival,  endeavor  to 
check  the  flow  by  causing  the  patient  to  snuff  up 
vinegar,  or,  in  default  of  this,  a  solution  of  alum 
and  salt,  or  by  plugging  the  nostrils  with  styptic 
or  other  form  of  cotton.  Pressure  should  like- 
wise be  exerted  upon  both  facial  arteries:  this 
may  be  accomplished  by  pushing  the  fingers 
firmly  against  the  lower  jaw-bone,  on  each  side, 
immediately  in  front  of  the  lower  part  of  the  mus- 
cles, which  are  prominently  visible  at  the  angles 
of  the  jaws  when  the  latter  are  firmly  clinched. 

Hemorrhage  from  the  Lungs  proper  is  rarely 
copious.  The  blood  is  coughed  up,  and  is  usually 
bright  red  and  frothy  from  contained  air-bubbles. 
When  this  form  of  bleeding  occurs,  the  patient 


ORDINARY  ACCIDENTS  AND  EMERGENCIES.    59 

should  be  put  to  bed,  and  bolstered  up  in  a  sit- 
ting position.  Cold  drinks  should  be  given,  and 
if  the  patient  is  not  too  weak,  cold  applications 
are  to  be  made  to  the  chest.  Salt  and  vinegar  are 
popularly  supposed  to  be  efficacious  in  checking 
pulmonary  hemorrhage,  and  may  be  given  in  the 
following  doses  every  fifteen  minutes:  vinegar, 
one  teaspoonful;  salt,  about  a  quarter  of  a  tea- 
spoonful. 

In  Hemorrhage  from  the  Stomach  the  blood 
is  vomited  up,  and  presents  a  characteristic  ap- 
pearance of  coffee-grounds,  from  having  been 
acted  upon  by  the  digestive  fluids.  Mixed  with 
food,  it  may  be  difficult  to  recognize.  The  first- 
aid  treatment  in  these  cases  calls  for  rest  in  bed, 
cold  drinks,  or  bits  of  ice,  vinegar  in  teaspoonful 
doses,  and  cold  applications  to  the  belly. 

In  Hemorrhage  from  the  Bowels  the  patient 
should  be  put  to  bed,  injections  of  ice-water 
given,  and  cold  applications  applied  to  the  belly. 


POISONING. 

By  the  term  poison  is  meant  any  substance  what- 
soever which,  taken  into  the  system  in  small  quan- 
tities, is  capable  of  producing  noxious  or  deadly 
effects. 

Poisons  may  be  classed  as  corrosive,  irritant, 
and  neurotic.  Corrosive  poisons  burn  the  parts 
with  which  they  come  in  contact ;  irritant  poisons 
cause  intense  inflammation  of  such  parts  ;  neurotic 


60    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

poisons  manifest  their  action  chiefly  through  the 
nervous  system. 

An  antidote  is  a  remedy  counteracting  the 
effects  of  a  poison,  either  by  uniting  with  it  and 
forming  a  harmless  compound,  or  by  exerting  an 
action  upon  the  system  which  is  opposed  to  and 
neutralizes  that  of  the  poison.  The  former, 
mainly,  will  concern  the  layman.  The  general 
principles  to  be  remembered  in  all  cases  of  poison- 
ing are,  that  the  poison  is  to  be  neutralized  and 
removed  as  soon  as  possible ;  that  any  irritant  or 
caustic  action  it  may  have  is  to  be  counteracted 
by  demulcent  (bland,  soothing)  fluids ;  that  if  col- 
lapse or  unconsciousness  threaten,  proper  meas- 
ures are  to  be  adopted  to  combat  the  tendency ; 
and  that  artificial  respiration  is  to  be  employed  if 
necessary. 

It  is  impracticable  within  the  limits  of  this 
manual  to  detail  the  first-aid  treatment  of  each 
and  every  case  of  poisoning  that  may  occur.  The 
above  rules,  however,  should  be  firmly  fixed  in 
the  mind  of  the  bearer.  Should  he  be  unac- 
quainted with  the  antidote  to  be  applied  in  any 
given  case,  he  should  not  lose  confidence,  but  do 
his  best  in  carrying  out  the  other  measures  indi- 
cated. 

To  illustrate  the  general  measures  mentioned, 
the  treatment  in  the  case  of  certain  common  poi- 
sons will  be  detailed  in  full.  Such  procedures  only 
will  be  given,  however,  as  the  layman  may  be  ex- 
pected safely  to  employ.  The  administration  of 
such  antidotes  as  are  themselves  powerful  poisons 


ORDINARY   ACCIDENTS,  ETC.— POISONING.    6l 

will  not  be  advised  ;  it  should  be  left  to  the 
surgeon. 

It  should  not  be  forgotten  that  when  poisoning 
has  occurred  the  surgeon's  services  should  be  pro- 
cured as  soon  as  possible. 

General  Measures  and  Remedies. — Under  the 
head  of  the  various  poisons,  certain  remedies  and 
measures  of  general  application  will  be  constantly 
referred  to;  in  order  to  avoid  the  necessity  of  de- 
tailing them  in  full  each  time,  it  will  be  well  to 
consider  them  before  taking  up  the  subject  of  the 
individual  poisons.  The  topics  in  question  in- 
clude the  use  of  emetics,  certain  antidotes,  bland 
liquids,  stimulants,  and  laudanum. 

Emetics. — Vomiting  may  be  produced  by  tick- 
ling the  throat  with  a  feather  or  the  finger,  or  by 
administering  warm  water,  solution  of  salt,  mus- 
tard, sulphate  of  zinc,  ipecac  and  water. 

Tickling  the  throat  with  a  feather  or  the  finger 
will  frequently  bring  on  vomiting.  When  an 
emetic  has.  already  been  given,  this  procedure 
will  hasten  its  action. 

Warm  water  is  to  be  given  in  as  large  quan- 
tities as  a  pint  at  a  time,  repeated  at  intervals  of 
a  minute  or  so. 

Salt  may  be  given  in  as  strong  solution  as  can 
be  made  with  water,  a  teacupful  of  the  brine  be- 
ing administered  every  miniite  or  two. 

Mustard  is  given  with  water  in  the  proportion 
of  one  tablespoonful  to  the  pint  of  fluid.  Copious 
draughts  of  tepid  water  assist  the  emetic  action. 


62    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

The  mustard,  moreover,  exercises  a  stimulating 
influence  on  the  system. 

Sulphate  of  Zinc  (white  vitriol)  is  a  valuable 
emetic.  It  is  given  in  twenty-grain  doses  (as 
much  as  may  be  heaped  on  a  silver  quarter), 
dissolved  in  water.  This  dose  should  be  followed 
by  a  cup  of  tepid  water,  and  repeated  every  three 
minutes  until  four  doses  have  been  given,  or  vom- 
iting has  occurred. 

Ipecac  is  given  with  water  in  the  proportion  of 
a  teaspoonful  of  the  powder  or  a  tablespoonful  of 
the  syrup  to  a  pint  of  fluid. 

Alkaline  Antidotes  are  employed  to  form 
compounds,  harmless,  or  comparatively  so,  with 
acids  in  cases  of  acid-poisoning.  They  include 
ammonia  diluted  (a  tablespoonful  to  two  teacup- 
fuls  of  water),  lime-water,  solution  of  baking-soda, 
bicarbonate  of  potash,  or  soap  and  either  or  several 
of  the  following  articles  mixed  with  water,  viz : 
chalk,  whiting,  whitewash,  tooth-powder,  plaster 
from  the  walls,  wood  ashes,  etc.  In  preparing  the 
mixture,  no  time  should  be  lost  in  endeavors  to 
make  a  perfectly  uniform  one.  A  little  grit  will 
do  no  harm. 

Acid  Antidotes  are  employed  to  form  harm- 
less or  comparatively  harmless  compounds  with 
acids  in  cases  of  poisoning  with  the  latter.  Those 
which  the  bearer  should  especially  remember  are 
vinegar  and  lemon-juice. 

Bland  Liquids  are  employed  to  soothe  the 
membranes  which  have  been  irritated  or  corroded 
by  the  action  of  a  poison.  They  include  beaten 


ORDINARY  ACCIDENTS,  ETC.— POISONING.    63 

eggs,  oil,  milk,  condensed  milk,  gruel,  barley- 
water,  arrow-root,  flour  and  water,  starch  decoc- 
tion, mucilage,  etc. 

Stimulants  may  be  necessary  in  cases  of  threat- 
ening collapse  or  unconsciousness.  They  include 
liquors,  wine,  tea,  coffee,  and  dilute  ammonia  (tea- 
spoonful  to  a  teacupful  of  water).  Tea  and  coffee 
are  furthermore  valuable  as  being  antidotes  to 
several  poisons,  on  account  of  the  tannin  they 
contain.  In  preparing  them  no  time  should  be 
lost  in  settling  or  straining.  Whiskey  may  be 
given  in  teaspoonful  doses,  with  tea  or  coffee,  or 
as  a  toddy.  Stimulants  may  be  given  by  the 
bowel. 

Laudanum  may  be  given  in  a  dose  of  twenty- 
five  drops  in  case  of  severe  pain.  This  dose  may 
be  repeated  in  thirty  minutes  if  the  pain  persists 
and  drowsiness  has  not  been  caused. 

Forcible  Administration  of  Remedies. — It 
may  sometimes  happen  that  the  patient  through 
perverseness  or  fright  will  refuse  to  open  his 
mouth  and  swallow  the  remedies  tendered,  or  he 
may  be  prevented  by  unconsciousness  from  so  do- 
ing. In  either  case  he  should  be  laid  upon  his 
back,  and  the  bearer  should  insert  both  thumbs 
into  his  (the  patient's)  mouth,  between  the  cheeks 
and  the  teeth  and  along  the  line  of  the  edges  of 
the  latter,  slipping  the  tips  of  the  thumbs  into  the 
space  behind  the  last  tooth  on  either  side.  The 
jaws  can  then  be  readily  separated,  the  bearer 
running  no  risk  of  having  his  fingers  bitten.  The 
handle  of  a  strong  spoon,  a  stick,  a  paper-cutter, 


64    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

or  other  available  article  should  then  by  a  second 
bearer  be  thrust  well  back  upon  the  tongue,  and 
used  as  a  tongue-depressor.  The  fluids  required 
may  thus  be  poured  down  the  patient's  throat 
without  trouble,  provided  the  tongue  be  suffi- 
ciently depressed. 

In  Poisoning  from  Unknown  Substances  the 
stomach  should  be  cleared  by  vomiting,  incited 
again  and  again.  Subsequently  bland  and  sooth- 
ing  drinks  may  be  given.  Pain  may  be  relieved 
by  laudanum,  in  doses  as  prescribed  on  page  63. 

Collapse,  if  it  occur,  is  to  be  treated  like  col- 
lapse in  general.  The  patient  is  to  be  put  to  bed, 
warmth  applied  in  the  form  of  hot  bottles,  bricks,  or 
stupes,  and  stimulants  and  hot  drinks  (tea,  coffee) 
are  to  be  administered.  A  teaspoonful  of  whiskey 
may  be  given  every  ten  minutes,  either  in  hot 
water,  or  in  hot  tea  or  coffee. 

Corrosive  Poisons  include  the  mineral  acids — 
sulphuric  (oil  of  vitriol),  nitric,  and  hydrochloric 
(muriatic);  oxalic  acid,  carbolic  acid  ;  the  alkalies — 
ammonia,  soda,  and  potash  ;  corrosive  sublimate, 
nitrate  of  silver  (lunar  caustic),  phosphorus,  and 
various  salts  of  different  metals. 

The  action  of  the  mineral  acids  and  the  alkalies 
is  especially  rapid  and  violent,  and  when  they  have 
been  taken  undiluted,  little  is  to  be  confidently 
expected  to  result  from  the  treatment  adopted. 

In  all  cases  of  poisoning  by  corrosives,  it  is  to  be 
understood,  without  further  specifying,  that  rest 
is  to  be  secured,  and  stimulants  administered,  if 
necessary  ;  that  collapse  is  to  be  treated  as  indi- 


ORDINARY  ACCIDENTS,  ETC. — POISONING.    6$ 

cated  in  the  preceding  paragraph  ;  and  that  pain  is 
to  be  relieved  in  the  manner  detailed  on  page  63. 

Sulphuric,  nitric,  and  hydrochloric  acids  are 
neutralized  by  alkalies.  The  alkaline  antidotes 
mentioned  on  page  62  are  all  useful  in  cases  of 
poisoning  with  these  substances,  and  should  be 
freely  administered. 

After  neutralization,  vomiting  should  be  pro- 
duced, and  bland  and  soothing  drinks  subsequently 
given. 

Carbolic  acid,  in  cases  of  poisoning  by  it,  calls 
for  repeated  emetic  draughts  and  large  quantities 
of  demulcent  drinks. 

Oxalic  acid  is  to  be  neutralized  by  lime,  as  with 
soda,  ammonia,  or  potash  salts  it  forms  com- 
pounds which  themselves  are  poisonous.  Chalk, 
lime,  whitening  or  whitewash,  stirred  up  in  water, 
or  lime-water  itself,  may  be  plentifully  adminis- 
tered. Magnesia  also  may  be  used.  After  thor- 
ough neutralization,  vomiting  should  be  brought 
on,  and  soothing  drinks  given. 

Ammonia,  soda,  and  potash,  the  Alkalies,  are 
to  be  neutralized  by  dilute  acids.  Vinegar  is  to 
be  given  in  as  large  quantities  as  a  pint  at  a  time, 
if  possible.  Lemon-juice  may  be  of  value  in  minor 
cases.  After  thorough  neutralization,  vomiting 
should  be  excited,  and  demulcent  drinks,  espe- 
cially olive-oil,  subsequently  administered. 

Lye,  a  preparation  containing  alkalies,  and  am- 
monia liniment  are  sometimes  a  source  of  alkali- 
poisoning. 

Corrosive    sublimate   is  both  neutralized  by 


66    THE  SOLDIER'S  FIRST  AID  HANDBOOK, 

white  of  egg  (raw)  in  large  quantities,  or  tannin, 
conveniently  given  in  the  form  of  strong  tea. 
Vomiting  should  be  produced  as  soon  as  possible, 
and  eggs  and  milk  subsequently  administered. 

Nitrate  of  silver,  lunar  caustic,  is  to  be  neutral- 
ized by  common  salt,  given  in  solution  and  in 
quantities  large  enough  to  produce  vomiting  at 
the  same  time.  Mustard  or  ipecac  may  be  also 
used  as  emetics.  Subsequently  bland  drinks 
should  be  administered. 

Phosphorus. — Poisoning  by  phosphorus  is  to 
be  treated  by  the  administration  of  calcined  mag- 
nesia and  water,  followed  first  by  an  emetic  and 
later  by  demulcent  drinks.  No  oils  or  fats  are  to 
be  given,  as  they  facilitate  the  absorption  of  the 
poison. 

Irritant  Poisons  may  be  classed  as  metallic, 
vegetable,  and  animal.  Examples  of  metallic  irri- 
tants are  arsenic,  certain  antimony,  lead,  and  zinc 
salts,  iodine  ;  of  vegetable,  croton-oil,  the  essen- 
tial oils,  gamboge,  etc. ;  of  animal,  cantharides 
(Spanish  fly). 

In  all  cases  of  irritant  poisoning  it  is  to  be  un- 
derstood that  rest  is  to  be  secured,  and  stimulants, 
when  necessary,  are  to  be  administered,  that  col- 
lapse is  to  be  treated  and  pain  relieved,  according 
to  the  principles  already  laid  down. 

Arsenic. — In  poisoning  by  arsenic  or  any  of  its 
preparations  ( Paris  green,  etc.)  vomiting  should 
first  of  all  be  induced.  Demulcent  drinks  are  to 
be  freely  administered,  as  they  dilute  the  poison, 
protect  the  stomach,  and  facilitate  vomiting.  Dia- 


ORDINARY  ACCIDENTS,  ETC.— POISONING.    67 

lyzed  iron  in  repeated  ounce  doses  (two  table- 
spoonfuls)  is  to  be  given  as  an  antidote,  each  dose 
being  followed  by  a  teacupful  of  brine.  In  de- 
fault of  dialyzed  iron,  equal  parts  of  the  sulphate 
of  iron  (green  vitriol)  and  carbonate  of  soda  may 
be  dissolved  in  separate  cups  of  hot  water,  mixed 
and  administered.  Large  quantities  of  calcined 
magnesia  in  water  may  be  used  if  the  iron  prepara- 
tions are  not  obtainable.  After  thorough  neutral- 
ization of  the  poison,  final  vomiting  should  be  in- 
duced, a  dose  of  castor-oil  given,  and  soothing 
drinks  administered. 

Tartar  emetic  is  to  be  neutralized  by  tannin 
administered  in  the  form  of  the  powder  itself, 
strong  tea,  nut-galls,  or  powdered  oak-bark.  One 
of  the  prominent  symptoms  of  poisoning  by  tartar 
emetic  is  vomiting ;  this  should  be  assisted  by  co- 
pious draughts  of  tepid  water  or  demulcent  drinks. 
A  teaspoonful  of  tannin  in  water,  strong  green 
tea,  or  half  a  dozen  nut-galls,  powdered  in  water, 
etc.,  may  then  be  given  as  an  antidote.  After 
the  poison  has  been  neutralized  and  the  stomach 
thoroughly  cleared  out,  demulcent  drinks  should 
be  administered. 

Lead. — Lead-poisoning  is  usually  caused  by 
the  sugar  of  lead,  which  is  to  be  neutralized  by 
sulphuric  acid  in  some  form,  or  the  soluble  sul- 
phates. A  teaspoonful  of  dilute  sulphuric  or 
aromatic  sulphuric  acid  and  an  ounce  of  Epsom 
salts  in  water  may  be  administered  as  an  antidote. 
Vomiting  is  to  be  produced,  and  bland  drinks 


68    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

should  be  administered,  together  with  a  purgative 
to  clear  the  bowels. 

Copper. — Poisoning  by  copper  salts  is  to  be 
treated  by  producing  vomiting  and  administering 
flour  water,  white  of  eggs,  and  milk,  in  large  quan- 
tities, both  as  antidotes  and  demulcents. 

Iodine  in  the  form  of  the  tincture,  taken  in- 
ternally, is  to  be  neutralized  by  starch  and  water. 

Irritant  vegetable  and  animal  substances.— 
In  poisoning  by  these  substances,  which  include 
croton-oil,  essential  oils,  cantharides,  etc.,  free 
vomiting  should  be  induced,  and  demulcent  drinks 
given  in  copious  quantities. 

Poisoning  by  tainted  meat,  tainted  fish,  or 
toadstools,  etc.,  is  to  be  treated  by  inducing  free 
vomiting,  administering  demulcent  drinks,  and 
giving  a  purgative  to  clear  the  bowels. 

Neurotic  Poisons  manifest  their  action  mainly 
through  the  nervous  system  ;  some  of  them,  how- 
ever, have  a  local  irritant  action  in  addition.  The 
former  are  narcotics,  simply ;  the  latter,  irritant 
narcotics.  The  best  known  among  narcotics  are 
opium,  chloral,  and  hydrocyanic  (prussic)  acid,  but 
aconite,  nux  vomica,  belladonna,  digitalis,  tobacco, 
etc.,  may  also  be  cited  as  irritant  narcotics. 

In  connection  with  vegetable  poisons  of  the 
neurotic  class,  it  should  be  remembered  that  the 
particular  substances  which  camse  poisoning  are 
such  as  form  comparatively  harmless  compounds 
with  tannin  :  hence  the  efficacy  of  strong  hot  tea 
or  coffee  in  these  cases,  not  only  as  a  stimulant, 
but  as  an  antidote,  should  be  borne  in  mind. 


ORDINARY  ACCIDENTS,  ETC.— POISONING.    69 

Opium. — Opium  is  a  narcotic.  Opium-poison- 
ing may  be  caused  either  by  the  solid  opium,  mor- 
phine, laudanum,  or  the  thousand  and  one  pain- 
killing  preparations  of  the  drug. 

When  poisoning  has  occurred  the  stomach  is  to 
be  promptly  and  repeatedly  emptied  by  an  active 
emetic  (mustard,  assisted  in  its  action  by  tickling 
the  throat  with  a  feather).  Tannin  and  strong  hot 
tea  is  then  to  be  liberally  given.  The  narcotic 
effect  of  the  drug  must  be  vigorously  combated. 
The  patient  should  be  roused  by  flapping  him 
with  a  wet  towel,  spanking  him  with  a  brush  or 
slipper,  walking  him  about,  pinching  him,  shout- 
ing at  him,  etc.  Ammonia  may  be  applied  to  the 
nostrils,  and  a  pint  of  hot  tea  or  coffee  injected 
into  the  bowels.  His  head  may  be  frequently 
douched  by  pouring  cold  water  from  a  height,  the 
patient  being  dried  off  at  intervals.  Artificial 
respiration  should  be  employed  when  the  breath- 
ing falls  below  eight  a  minute  ;  it  may  be  contin- 
ued for  hours.  Warmth  is  to  be  applied  if  the 
bodily  temperature  fails. 

Chloral  calls  for  much  the  same  treatment  as 
epium. 

Hydrocyanic  Acid,  or  prussic  acid  is  so  rapid 
in  its  action  and  so  readily  absorbed,  that  there  is 
no  time  for  the  employment  of  emetics.  The 
bearer  will  have  to  confine  himself  to  counteract- 
ing the  paralyzing  effects  of  the  drug  by  cold 
douches,  applications  of  ammonia  to  the  nostrils, 
stimulant  injections  into  the  bowels,  and  artificial 
respiration. 


70    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

Irritant  Narcotics. — In  poisoning  from  aconite, 
belladonna,  atropine,  nux  vomica,  strychnine,  digi- 
talis, tobacco,  hemlock,  Jamestown  weed,  etc.,  the 
stomach  is  to  be  promptly  and  repeatedly  emptied 
by  an  emetic.  Tannin,  hot  tea,  coffee,  and  stim- 
ulants are  then  to  be  administered,  warmth  ap- 
plied, if  necessary,  and  artificial  respiration  prac- 
tised, if  called  for.  The  powerful  antidotes  are 
not  safe  in  the  hands  of  the  bearer,  and  should  be 
administered  only  by  the  surgeon. 

By  Poisoned  Wounds  are  meant  such  as  have 
been  poisoned  by  the  instrument  or  agent  inflict- 
ing them.  They  include  the  bites  inflicted  by 
certain  animals  and  insects,  dissection  wounds, 
etc. 

The  bite  of  a  venomous  serpent  is  to  be 
treated  by  preventing  absorption  of  the  poison, 
destroying  or  removing  it,  and  combating  symp- 
toms of  collapse.  Absorption  is  prevented  by 
tying  a  cord  tightly  around  the  limb  immediately 
above  the  wound.  The  poison  may  be  removed 
by  forcibly  sucking  the  wound,  provided  the  lips 
are  not  chapped  or  sore ;  it  may  be  destroyed  by 
burning  the  wound  with  gunpowder  poured  in  it 
and  touched  off  by  a  live  coal,  etc.,  or  by  cauteriz- 
ing with  ammonia,  caustic,  acid.  To  combat  the 
constitutional  symptoms  of  the  poison,  rest  should 
be  secured  and  alcoholic  stimulants  given  in  large 
doses  until  intoxication  is  produced,  which  should 
be  kept  up  until  arrival  of  the  surgeon. 

The  bite  of  a  mad  dog  or  other  rabid  ani- 
mal requires  treatment  similar  in  principle  to  that 


ORDINARY  EMERGENCIES — POISONED  WOUNDS.  7 1 

detailed  above.  Alcoholic  stimulants,  however, 
are  not  necessary. 

The  stings  of  tarantulas,  centipedes,  in- 
sects, etc.,  are  to  be  treated  with  cold  applica- 
tions. Hartshorn  applied  to  the  part  will  neu- 
tralize the  poison. 

Rhus  Poisoning. — Poison-ivy,  poison-oak,  and 
poison-sumach  often  produce  an  eruption  of  the 
skin  attended  with  a  good  deal  of  redness,  itching, 
swelling,  and  even  blistering. 

Weak  alkaline  solutions,  lime-water,  applied  on 
lint,  are  useful.  Laudanum  maybe  used  to  re- 
lieve pain. 

TABLE  OF  POISONS. 

NAME.  FIRST-AID  TREATMENT. 

Induce  vomiting  repeatedly, 
Give     bland      and      soothing 
drinks, 

UNKNOWN i    Relieve  pain, 

Stimulate  in  case  of  collapse, 
Employ   artificial   respiration 
if  necessary. 

CORROSIVES. 

{Give  alkaline  antidotes, 
Induce  vomiting, 
Give  bland  liquids, 
Stimulate  if  necessary, 
Secure  rest, 
Relieve  pain. 

Give  mixture  of  water  and 
chalk,  magnesia,  lime,  or 
whitewash, or  lime-water, 

Give  no  alkalies, 


Oxalic., 


Induce  vomiting, 
Give  soothing  drinks, 
Stimulate,  if  necessary, 
Secure  rest, 
Relieve  painf 


72    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 


Alkalies : 

Ammori  a, 

Soda, 

Potash, 

Lye, 

Hartshorn  liniment, 


Corrosive  sublimate. 


Nitrate  of  silver  (lunar  caustic). 


NAME.  FIRST  AID  TREA  TMENT. 

CORROSIVES. 

Give  acid  antidotes,  especially 

vinegar, 

Induce  vomiting, 
Give  bland  liquids  (e.g.,  sweet 

oil), 

Secure  rest, 

Stimulate,  if  necessary, 
Relieve  pain. 

Give  whites  of  egg  (raw),  or 
tannin  (solution,  strong 
tea,  coffee), 

Induce  vomiting, 

Give  eggs  and  milk, 

Give  a  dose  of  castor-oil, 

Secure  rest, 

Relieve  pain. 

Give  solution  of  salt  in  large 
quantities,  as  antidote 
and  emetic, 

Giye  soothing  drinks. 

Give    calcined    magnesia    in 

water, 
Phosphorus «j    Induce  vomiting, 

Give  bland  liquids  (no  oils  of 
fats). 

IRRITANT  POISONS. 

Induce  vomiting  at  once, 
Give  the  "antidote  for  arsen- 
ical poisoning"  on  hand 
in  dispensary, 
Dialyzed  iron,  or 
Calcined  magnesia, 
Induce    vomiting    after  each 

dose  of  the  antidote, 
Give  a  dose  of  castor-oil, 
Soothing  drinks, 
Stimulate,  if  necessary, 
Relieve  pain, 
Secure  rest. 
Give     tannin     (as    solution, 

strong  tea,  coffee), 
Encourage  vomiting,  by  large 
draughts  of  tepid  water, 
or  bland  liquids, 
Give  soothing  drinks, 
A  dose  of  castor  oil,  and 
Stimulants,  if  necessary. 


Arsenic,         ) 
Paris  green.  ] 


Tartar  emetic. 


TABLE   OF 


NAME.  FIRST  < 

IRRITANT  POISONS. 

Give  Epsom  salts,  in  water, 


Lead  preparations  (sugar  of  ) 
lead,  etc.) f 


Essential  oils, 
Croton  oil, 
Cantharides 

(Spanish  fly). 
Tainted  meat,  ) 
Tainted  fish,  V 
Toadstools.  ) 


Induce  vomiting, 
Give  soothing  drinks, 
Dose  of  castor-oil. 
Induce  vomiting, 
Give  flour  and  water, 

Copper  preparations -i   White  of  eggs  (raw),  or 

Milk  in  copious  quantities, 
Dose  of  castor-oil. 

T   j.  j   Give  starch  and  water, 

ne }   Induce  vomiting. 

(Induce  free  vomiting, 
Give  bland  drinks  in  copious 
quantities, 
Relieve  pain. 
(   Induce  free  vomiting, 

•<   Give  bland  liquids, 

(  Castor-oil  (a  dose). 

NEUROTIC  POISONS. 

Induce  vomiting    by    giving 
mustard-water   and  tick- 
ling throat, 
Give  tannin  (solution,  strong 

tea,  coffee), 
Keep  patient  aroused, 
Employ  artificial  respiration, 
Apply  warmth, 
L  Stimulate, 
f  Induce  vomiting, 

JKeep  patient  aroused, 
Employ  artificial  respiration, 
j   Apply  warmth, 
L  Stimulate. 

{Apply  ammonia  to  nostril, 
Employ   stimulant   injections 
into  bowel, 
Artificial  respiration. 

IRRITANT  NARCOTICS. 

Induce  vomiting, 

Give  tannin  (solution,  hot  tea, 

coffee), 
Stimulants, 

Apply  warmth  to  body, 
Artificial  respiration, 
Secure  rest, 
Relieve  pain. 


otics :      1 

ium, 

ndanum,  f 

>rphine.   J 


Narcotics : 
Opium, 
Laudanum 
Morphi 


Cyanides. 


Aconite  (monk's-hood), 

Belladonna  (nightshade), 

Atropine, 

Nux  vomica, 

Strychnine, 

Hemlock, 

Jamestown  weed,  etc. 


74    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

NAME.  FIRST  AID  TREATMENT. 

POISONED  WOUNDS. 

Tie  cord  tightly  around  limb 

above  wound, 
Cauterize   wound    with    acid, 

ammonia,  live  coal, 


Bites  of  venomous  serpents. . , 


Touch     off      gunpowder      in 

wound, 
Suck   wound  if   lips    are  not 

chapped  or  teeth  hollow, 
Cut  out  the  part  bitten, 
Produce  intoxication. 

Treat  as  above,  with  the  ex-, 

Bites  of  rabid  animals -J          ception   of  producing  in< 

toxication. 


f  Apply  ammonia, 


Stings  of  tarantulas,  centi-  )       )   Employ  cold  applications, 
pedes,  insects.  'I   Stimulate,     if    depression   is 

caused. 


FOREIGN  BODIES  IN  THE  EYE,  EAR, 
OR   NOSE. 

Foreign  Bodies  in  the  Eye,  such  as  cinders, 
sand,  chips  of  metal,  etc.,  may  be  removed  in 
various  ways.  Frequently  the  eye  relieves  itself 
of  the  irritating  substance  by  washing  it  out  with 
a  copious  flow  of  tears. 

Should  this  natural  method  of  dislodgement 
fail,  and  the  foreign  body  is  seen  on  the  globe  of 
the  eye,  it  may  be  brushed  away  with  a  camel's- 
hair  pencil  or  the  corner  of  a  handkerchief;  if 
partly  imbedded,  it  should  be  lifted  out  with  the 
point  of  a  lancet  or  scalpel,  the  instrument  being 
applied  on  the  flat  and  used  with  extreme 
caution. 

Again,  the  upper  eyelid  may  be  seized  by  the 
lashes  and  drawn  down  over  the  lower  one. 
When  it  is  released,  its  under  surface  is  swept  by 


FOREIGN  BODIES  IN  THE  EYE,  EAR,  OR  NOSE.   75 

the  lower  eyelashes,  and  if  the  foreign  body  is 
within  reach,  it  will  probably  be  caught,  as  on  a 
brush. 

Another  method  of  removing  a  foreign  body 
from  the  under  surface  of  the  upper  eyelid  is  as 
follows : 

The  upper  eyelid  being  drawn  down,  a  probe, 
slender  pencil,  toothpick,  or  match  is  placed 
firmly  against  it,  parallel  to  its  edge,  and  close  to 
the  margin  of  the  orbit.  The  upper  lashes  are 
then  seized  by  the  disengaged  hand,  the  patient 
is  instructed  to  look  downwards,  and  the  lid  is 
then  gently  folded  backward  over  the  probe  or 
its  substitute.  The  foreign  body  is  then  to  be 
brushed  away  with  a  camel's-hair  pencil,  or  the 
corner  of  a  handkerchief,  or,  if  imbedded,  care- 
fully removed  with  the  flat  surface  of  a  blunt- 
edged  scalpel,  lancet,  or  pen-knife. 

The  under  surface  of  the  lower  eyelid  is  very 
readily  examined. 

After  removal  of  a  foreign  body  the  irritation 
caused  by  it  may  be  soothed  by  instilling  a  few 
drops  of  olive-  or  castor-oil,  and,  if  necessary,  by 
cold  applications. 

It  must  be  borne  in  mind  that  often  after  re- 
moval of  a  foreign  body  a  sensation  remains  as  if 
it  were  still  present. 

When  caustic  substances  like  lime,  ammonia, 
and  acids  have  entered  the  eye,  the  organ  should 
be  promptly  deluged  with  water.  Lime  and  am- 
monia are  then  to  be  neutralized  by  diluted  vine- 
gar or  lemon-juige  (teaspoonful  to  teacupful  of 


76    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

water),  and  acids  by  weak  solutions  of  bicarbonate 
of  soda. 

Foreign  Bodies  in  the  Ear. — Insects  in  the 
ear  may  be  dislodged  by  holding  the  head  with 
the  affected  ear  upward  and  filling  the  canal  with 
warm  oil,  glycerine,  or  salt  and  water.  The  in- 
sect will  in  short  time  drown  and  float  to  the 
surface  of  the  fluid,  when  it  may  easily  be  re- 
moved. 

Wax  is  to  be  softened  by  oil  dropped  into  the 
canal,  which  is  then  to  be  plugged  with  a  pledget 
of  cotton;  after  a  number  of  hours  the  pledget 
may  be  removed,  and  the  canal  syringed  out  with 
warm  water  until  the  wax  is  discharged. 

Bodies  within  easy  reach  may  be  removed  by 
the  forceps  or  a  hair-pin. 

If  the  foreign  body  is  not  accessible,  the  ear 
should  be  carefully  syringed. 

In  syringing  the  ear,  the  method  to  be  pur- 
sued is  as  follows : 

The  patient  or  an  assistant  holds  a  cup  or  ves- 
sel under  the  ear  to  catch  the  fluid.  The  bearer 
seizes  the  lobe  of  the  ear  and  draws  it  upward, 
outward,  and  backward,  in  order  to  straighten  out 
the  canal.  The  point  of  the  ear  syringe  is  directed 
successively  to  every  side  of  the  foreign  body, 
care  being  taken  not  to  use  too  much  force  in  de- 
livering the  stream  of  warm  water. 

Instead  of  the  ear  syringe  a  Davidson  or  foun- 
tain syringe  may  be  used,  the  head  of  the  patient 
being  held  face  downward.  The  nozzle  of  the 
syringe,  however,  is  not  to  be  introduced  into  the 


FOREIGN  BODIES  IN  THE  EYE,  EAR,  OR  NOSE.   77 

canal,  as  it  might  prevent  the  escape  of  the  for- 
eign body. 

Foreign  Bodies  in  the  Nose. — In  cases  of  for- 
eign body  in  the  nostril,  the  bearer  should  close 
the  affected  nostril  with  the  finger  and  instruct 
the  patient  (generally  a  child)  to  take  a  deep 
breath.  Then  removing  his  finger,  closing  the 
other  nostril  with  it,  and  the  mouth  with  his 
hand,  he  causes  the  patient  to  exhale  forcibly, 
clapping  him  smartly  on  the  back  as  he  does  so. 
By  this  procedure  the  foreign  body  may  be  dis- 
lodged. 

If  the  object  is  near  the  opening  of  the  nostril, 
the  bearer  may,  with  his  fingers,  compress  the 
nose  above  it  and  effect  removal  by  means  of  a 
pair  of  forceps,  hair-pin,  toothpick,  bent  wire. 

The  surgeon's  services  should  be  obtained 
without  delay  if  the  above  measures  prove  un- 
successful. 

MISCELLANEOUS  HINTS. 

Constipation. — A  Seidlitz  powder  taken  before 
breakfast  will  relieve  a  mild  constipation.  A 
tablespoonful  of  Rochelle  or  Epsom  salts  before 
breakfast,  a  teaspoonful  of  compound  liquorice 
powder,  three  or  four  compound  cathartic  pills 
late  at  night,  or  a  tablespoonful  of  castor-oil  are 
safe  purgatives. 

Colic  is  a  violent  pain  in  the  bowels  caused  by 
the  presence  of  undigested  food.  A  dose  of  castor- 
oil  will  remove  the  offending  material  Hot  ap- 


78    THE  SOLDIER'S  FIRST  AID  HANDBOOK. 

plications  may  be  applied  to  the  belly  if  practi- 
cable, and  a  teaspoonful  of  Squibb's  mixture,  ginger 
essence,  given  in  water. 

In  Cholera  Morbus  the  first  thing  to  do  gen- 
erally is  to  subdue  the  pain.  Half  a  teaspoonful 
of  laudanum,  a  quarter  of  a  grain  of  morphine,  or  a 
teaspoonful  of  Squibb's  mixture  diluted  may  be 
given  at  once.  At  the  same  time  hot  applica- 
tions should  be  applied  to  the  belly  if  practicable. 
Stimulants  may  be  necessary  in  case  of  collapse. 

Diarrhoea  is  often  an  effort  of  nature  to  rid 
the  bowels  of  hurtful  material.  To  encourage 
this  effort,  a  dose  of  castor-oil  may  be  given.  If, 
after  the  oil  has  acted,  diarrhoea  still  persists,  a 
teaspoonful  of  Squibb's  mixture  diluted,  or  a 
camphor  and  opium  pill,  may  be  administered,  to 
be  repeated  in  an  hour  or  two,  if  necessary. 

THE  SIGNS  OF  DEATH. 

The  Signs  of  Death. — Frequently  the  occur- 
rence  of  death  will  be  immediately  apparent  from 
the  character  of  existing  wounds  or  injuries  : 
should  this  not  be  the  case,  the  bearer  will  look 
for  absence  of  circulation  of  the  blood,  absence  of 
breathing,  general  ashy  paleness  of  the  skin,  and 
its  deep  discoloration  from  settling  of  the  blood  in 
those  parts  which  in  the  position  of  the  body  are 
undermost ;  dulness  and  glazing  of  the  eye,  cooling 
of  the  body;  the  rigor  mortis,  or  death-stiffness 
coming  on,  as  a  rule,  after  some  hours  ;  and  finally 
putrefaction. 


ORDINARY  ACCIDENTS  AND   EMERGENCIES.    79 

Absence  of  circulation,  clearly  shown,  is  a  posi- 
tive sign  of  death.  Cessation  of  the  action  of  the 
heart  may  be  established  by  listening  carefully 
over  the  region  of  the  heart  for  its  sounds,  or  feel- 
ing for  its  beat  to  the  left  of  the  breast-bone  in 
the  space  between  the  fifth  and  sixth  rib. 

Absence  of  breathing  will  be  apparent  from 
the  following:  The  sound  of  breathing  cannot  be 
heard  when  the  ear  is  applied  to  the  chest,  and  no 
chest  motion  is  perceptible.  A  mirror  or  highly 
polished  surface  held  to  the  mouth  will  not  be- 
come coated  with  a  film  of  moisture,  as  it  would  if 
held  to  the  mouth  of  a  breathing  person.  A  tuft  of 
down,  etc.,  placed  upon  the  lips  will  fail  to  dis- 
close any  movement  of  air-currents. 

The  bearer  will  do  well  not  to  rely  upon  any 
limited  number  of  signs.  The  above  are  the  prin- 
cipal ones ;  putrefaction  is  not  necessary  to  estab- 
lish death  when  they  are  associated  with  a  num- 
ber of  the  others. 


BOOKS  OF  REFERENCE. 


Encyclopaedic  Index  of  Medicine  and  Surgery.     Bermingham. 

Reference  Handbook  of  Medical  Sciences.     Buck. 

Physiology.     Dalton. 

What  to  do  First  in  Emergencies.     Dulles. 

Manual  of  Drill  for  the  Hospital  Corps  and  Company  Bearers. 

Havard. 

Instruktionsbuch  fiir  den  Krankentrftger.     Hering. 
The  Surgeon's  Handbook.     Porter. 
Handbook  for  the  Hospital  Corps.     Smart. 
Military  Hygiene.     Woodhull. 

81 


INDEX. 


A. 

PACE 

Abdomen,  organs  of 15-18 

"          wounds  of 23 

"  "       ''  position  of  patient    upon   litter  in 

cases  of 22,  23 

Accident,  general  rules  in  cases  of 46 

Acids,  poisoning  by 64,  65,  69,  71 ,  72 

"      in  the  eye 75 

"      as  antidotes 62 

Aconite,  poisoning  by 7°~73 

Administration,  forcible,  of  remedies 63 

Aid,  first,  on  the  battle-field 21-23 

Alkalies,  poisoning  by 65-72 

Ammonia,  poisoning  by 65-72 

"         in  the  eye 75 

Animation,  suspended 43~45 

Antidotes,  classification  of 62,  71-74 

"         alkaline 62-72 

"         acid 62-71 

Aorta 14-18 

Apoplexy 48,  49 

Arsenic,  poisoning  by 66-72 

Arteries,  the 18-20 

"        bleeding  from  (see  Hemorrhage) 27 

"        location  of  the  principal 18-20 

Artificial  respiration 44 

Asphyxia 51-54 

83 


84  INDEX. 

PACK 

Astringents 78 

Atropine,  poisoning  by 7O-73 

Axis,  cerebro-spinal n 

B. 

Backbone 5 

Bandage,  roller 25 

"        triangular 26 

"        elastic 26 

Bearers,  equipment  of 24 

"        limitation  of  duties  of 24 

"        Company 24 

"  "      duties  of 21-23 

Belladonna,  poisoning  by 68-73 

Belly,  the 15-18 

"        "  wounds  of  the 23 

"        "        "        "     "  position  of  patient  upon  litter  in. 23-35 

Bending  of  limb  to  produce  pressure  upon  artery 30,  31 

Bile 16 

Bile-duct 16 

Bite  of  serpent 7O~74 

"     mad  dog  or  other  rabid  animal 70,  71-74 

Bladder,  the 17 

Bland  liquids 62,  63 

Blisters,  from  marching , . ..  .57,  58 

Blisters,  puncture  of 58 

Bleeding  (see  Hemorrhage) 58,  59 

Blood-vessels,  location  of  principal  18-20 

Body,  the  human 2-20 

Bones,  the 2-8 

Bowels,  the 16 

"      "  bleeding  from 59 

Brain,  the 10,  II 

"     compression  of > ....     48 

"     concussion  of 48 

Breathing .». 13 

"        rate  of 13 

"        artificial  (see  Respiration,  artificial) 44>  45 


INDEX.  85 

PAGE 

Bruises 34 

Burns 55,  5& 

C. 

Canal,  spinal 5 

Canthandes,  poisoning  by 66,  73 

Capillaries,  the 14 

Capsule  of  joint 8 

Carbolic  acid,  poisoning  by 65 

Cartilage 6 

Caustics  in  the  eye 75 

Chest,  the 5, 12 

"      bones  of  the 5 

"     organs  of  the 12 

Chilblains 57 

Chloral 69 

Choking 54 

Cholera  Morbus 78 

Circulation,  the  general I3~i5»  J8,  19 

"          systemic 13,  14,  18,  19 

"          pulmonary 13-15 

Coffee,  hot,  as  an  antidote  63,  64,  69,  70,  72,  73 

Colic 77 

Collapse  (see  Shock) 33,  37,  38 

Column,  spinal 5,  n 

Compound  fractures 38,  39 

Compress 25 

Compression  of  the  brain 48 

Concussion  of  thv,  brain 48 

Connective  tissue 9 

Consciousness,  loss  of 47 

Constipation 77 

Contusions • 34 

Copper,  poisoning  by 68,  73 

Cord   spinal n 

Corps,  Hospital 24,  25 

Corrosive  sublimate,  poisoning  by 65 ,  66 

Cranium,  the 3 

"        bones  of  the 3 


86  INDEX. 


PAGE 

Cranium,  organs  of  the  cavity  of  the 10,  1 1 

Crepitus 38 

Croton-oil,  poisoning  by 66,  73 

Cuts 15,  23,  27,  35 

Cut  belly,  position  of  patient  in  transportation 35 

Cut  throat,  position  in  which  head  should  be  kept  in 23 

D. 

Death,  signs  of 78,  79 

Diaphragm 12 

Diarrhoea 18 

Digitalis,  poisoning  by 68,  73 

Dislocation 43 

Dog,  bite  of  mad .70,  74 

Dressing  station 22 

Drowning .51-53 

Drunkenness 50 

E. 

Ear,  foreign  bodies  in  the 76,  77 

Emetics  applicable  in  cases  of  poisoning. . .    61,  62 

Epileptic  fit 50 

Equipment,  the  bearer's 24 

Esmarch's  package 24 

Essential  oils,  poisoning  by 68,  73 

Excretions 1 7,  54 

Exhaustion  from  heat 49,  50 

Eye,  foreign  bodies  in  the 74,  75 

F. 

Face,  the 4 

"     bones  of 4 

Fainting 33 

Feet,  soreness  of  the 57 

Fish,  tainted,  poisoning  by 68 

Fingers,  used  to  apply  pressure 7,  28-31 

Fit,  epileptic 50 

Flexion  of  limb  to  produce  pressure  upon  artery 30,  31 


INDEX.  87 

PAGE 

Foreign  bodies  in  the  eye 74,  75 

"        "       ear 76,77 

"       nose 77 

"        "       windpipe  and  gullet 54 

Foxglove,  poisoning  by 70,  73 

Fractures  in  general 38 

special 39-42 

"        compound 38,  42 

"        position  of  patient  upon  litter  in  cases  of 39 

Freezing 56 

Frost-bites 56,57 

G. 

Gall-bladder 16 

Gases,  suffocation  caused  by 53 

Gastric  juice 16 

Glands 17 

Gristle 6 

Gullet  16 

H. 

Handkerchief  to  produce  pressure  in  hemorrhage 29 

Hanging,  strangulation  from 53 

Head,  organs  of  the  lesser  cavities  of  the 12 

Heat  exhaustion ,..49,50 

Heart,  the 13-15 

Hemlock,  poisoning  by 70,  73 

Hemorrhage,  capillary 27,31-33 

in  general 26-30 

"  venous 28 

"  arterial 28-30 

"  from  the  artery  of  the  neck 30 

"  "     "         "          "     arm  in  its  uppermost 

portion 30 

Hemorrhage  from  the  artery  of  the  arm  in  its  lower  por- 
tion      31 

Hemorrhage  from  the  arteries  of  the  fore-arm 31 

"  "     "     hand. ..... , ...... ,, 31 


88  INDEX. 

PAGE 

Hemorrhage  from  the   thigh 32 

"     "    leg 32 

"     "     foot 32 

internal 32 

"  on  reaction  from  fainting 33 

from  the  nose 58 

"     "    lungs 58,59 

"  "     "     stomach 59 

"  "     '*     bowels 59 

"     "     great  cavities,    position  of  patient 

upon  litter  in  cases  of . . . . , 22,  35 

Hydrochloric  acid,  poisoning  by 65,  71 

Hydrocyanic  acid,  poisoning  by 68,  73 

I. 

Insects,  in  ear 76 

sting  of 71,  74 

Insensibility 48,49 

Intestines 35 

Intoxication 50 

Ipecac  as  an  emetic 62 

j. 

Jamestown  weed,  poisoning  by 70,  73 

Joints,  the 8 

"      parts  forming 8 

Juice,  gastric 16 

K. 

Kidneys,  the 17 

Knotted  cloth  used  to  apply  pressure  in  hemorrhage 29 

L. 

Laudanum,  use  of,  in  case  of  pain  from  poisoning 63,  71 

poisoning  by 73 

Lead,  poisoning  by ,.,., 67 


INDEX.  89 

PAGE 

Ligaments,  the , 8 

Limbs,  upper,  bones  of t . . .       6 

11      lower,  bones  of 6 

Lime  in  the  eye 75 

Lint  and  its  substitutes 25,35 

Liquids,  bland 62,  63 

Litter,  position  of  wounded  upon 22,  23 

Liver,  the 1 6 

Lungs,  the , 12, 13 

"      bleeding  from 58,59 

"      position  of  patient  upon  litter  in  cases  of  wound  of,     23 

Lye,  poisoning  by 65,  72 

Lymphatics,  the 10 

M. 

Meat,  tainted,  poisoning  by 68 

Medicine  chest,  the  bearer's 24 

Membranes  of  brain 10 

Method,   Silvester's 44,  45 

Midriff,  the 12 

Morphine,  poisoning  by 68,  73 

Muriatic  (hydrochloric)  acid,  poisoning  by 64,  71 

Muscles,  the 9 

N. 

Neck,  position  in  which  head  should  be  kept  in  wounds  of 

front  of 23 

Nerves ro-i  2 

Nitrate  of  silver,  poisoning  by 64,  66,  72 

Nitric  acid,  poisoning  by 71 

Nose,  bleeding  from 58 

"    foreign  body  in 77 

O. 

Oil,  Croton,  poisoning  by 68,  73 

Oils,  essential,  poisoning  by 68,  73 


QO  INDEX. 


PACK 


Oil  of  vitriol  (sulphuric  acid),  poisoning  by 65,  71 

Opium,  poisoning  by 69,  73 

Oxalic  acid,  poisoning  by 65,  71 

P. 

Package,  Esmarch's , 24 

Pad  and  bandage,  to  produce  pressure  in  hemorrhage 29,  30 

Pancreas,  the 17 

Paris  green,  poisoning  by 66,  72 

Parts,  the  soft 9 

Pelvic  cavity,  organs  of 15-17 

Pelvis,  bones  of 6 

Peritoneum,  the 18 

Phosphorus,  poisoning  by 66 

Pleurae,  the 12 

Plug  and  bandage  to  produce  pressure  in  hemorrhage. ...     28 

Poisoning 59-74 

"        definition  of  a  poison 59 

"         classification  of  poisons 59 

"        general  measures  and  remedies 60,  61 

"        by  unknown  substances ....     64 

"         by  corrosive  substances 64 

sulphuric,  nitric,  and  hydrochloric  acids. ...     64 

carbolic  acid 65 

"  oxalic  acid 65 

ammonia,  potash,  and  soda 65 

"  corrosive  sublimate 65,  66 

"  lunar  caustic,  nitrate  of  silver 66 

phosphorus 66 

"        by  irritant  metallic  substances 66 

arsenic 66,  72 

"  tartar  emetic 67,72 

"  lead 67,73 

"  copper 68,73 

"         by  irritant  vegetable  and  animal  substance^.  ..68,  73 
"         by  tainted  meat,  tainted  fish,  toadstools. ...  ..68,  73 

"         by  narcotics 68,73 

"  opium , 69,  73 


INDEX.  91 

PAGE 

Poisoning  by  chloral 69,  73 

"  hydrocyanic  or  prussic  acid 69,73 

"         by  irritant  narcotics. . .  .  70,  73 

"  aconite,  belladonna,  digitalis 70,73 

Jamestown  weed,  hemlock,  etc 70,  73 

Poison  ivy  and  poison-oak  eruption 71 

Poisoned  wounds 70,  74 

Potash,  poisoning  by 65,  72 

Powder  for  sore  feet 57,  58 

Pressure,  methods  of  applying,  in  hemorrhage 28-33 

Prussic  (hydrocyanic)  acid,  poisoning  by 69,  73 

R. 

Respiration,  rate  of -13 

artificial 44 

Sylvester's  method  of  artificial 44,  45 

"  (see  Breathing) 13 

Rhus  poisoning 71 

S. 

Salt  as  an  emetic 61 

Scalds 56 

Secretions 17 

Seizures,  epileptic 50 

Seminal  vesicles 17 

Serum 18 

Shock  accompanying  severe  injury. 37 

"     fright,  despondency,  hunger,  and  thirst  as  favoring,  37,38 

"    as  a  result  of  extensive  burns  or  scalds 56 

Silver,  nitrate  of,  poisoning  by 66,  72 

Silvester's  method 44,  45 

Skeleton,  the 2,  3 

Skin,  the 9,  10 

Skull,  the 3,  4,  10 

Snake-bites 70,  74 

Soda,  poisoning  by 65,72 

Soft  parts,  the 9-11 


92  INDEX. 

PACK 

Soreness  of  the  feet 57 

Spine 5,11 

Spinal  column 5 

"  cavity,  organs  of 10 

Spleen,  the 17 

Splints  26 

"  improvised 26,  39-42 

Sprains 42 

Stimulants  in  cases  of  poisoning 63,  66,  68-73 

Stings,  of  tarantulas,  centipedes,  insects,  etc 71,  74 

Strangulation  from  hanging 53 

Stomach,  the , .  16 

"  bleeding  from 59 

Strychnine,  poisoning  by  68,  73 

Stunning  (see  Concussion  of  the  Brain) , .  48 

Styptics. . , 25,  27,  29 

Sublimate,  corrosive,  poisoning  by 64,  72 

Suffocation  with  gases 53 

from  foreign  bodies  in  windpipe  or  gullet 54 

Sugar  of  lead,  poisoning  by 67,  73 

Sulphate  of  zinc,  as  an  emetic. 62 

Sulphuric  acid,  poisoning  by 64,  65,  71 

Sunstroke 49 

Sutures  of  the  skull 4 


T. 

Tannin  as  an  antidote 67,  72,  73 

Tartar  emetic,  poisoning  by 67,  72 

Tea,  hot,  as  an  antidote 68,  69,  72,  73 

Teeth,  the 4 

Temperature,  normal,  of  the  body 15 

Thorax,  the 5 

"      bones  of  the 5,6 

"       organs  of  the  cavity  of  the 12-15 

Tickling  the  throat  to  produce  vomiting 61,  69,  73 

Tourniquet 26,  29-32,  37 

Tobacco,  poisoning  by 70, 73 


INDEX.  93 

U. 

PAGE 

Unconsciousness 47 

"  position  of  patient  upon  litter  in  cases  of,  47,48 

Ureters 17 

Urethra 17 

Urine,  the 17 

"      daily  quantity  of 17 

V. 

Veins,  the 14,  20 

"  location  of  principal 14,  18,  19,  20 

"  bleeding  from 15,27,28 

Vomiting,  how  produced 61,  62,  66,  69 

when  to  be  produced 64-74 

W. 

Warm  water  as  an  emetic 61,  62,  72 

Wax  in  ear 76 

Windlass,  Spanish 26,  29-32 

Wounds  in  general 21,  27,  33 

"      contused 34 

"      incised 35 

"      punctured 35 

"      lacerated 36 

"      gunshot 36 

"      poisoned 70 

"      of  belly 23,  35 

"      position  of  patient  upon  litter  in  cases  of 23,  35 

Wounded  in  battle,  general  management  of 21-23 

Z 
Zinc  sulphate  as  an  emetic 62 


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THIS  BOOK  ON  THE  DATE  DUE.  THE  PENALTY 
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OVERDUE. 


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MAY  16  1960 

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NOV  1  0  196fr 

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